ANTIBODY-DRUG CONJUGATES TARGETING uPARAP

ABSTRACT

The present invention relates to conjugates targeting uPARAP, in particular antibody-drug conjugates (ADCs) comprising monoclonal antibodies directed against the N-terminal region of uPARAP, and their use in delivery of active agents to cells and tissues expressing uPARAP. The invention further relates to the use of said ADCs in the treatment of diseases involving uPARAP expressing cells, such as cancer.

FIELD OF INVENTION

The present invention relates to molecular conjugates targeting thereceptor uPARAP, in particular antibody-drug conjugates (ADCs) directedagainst uPARAP and their use in delivery of active agents to cells andtissues expressing uPARAP. The invention further relates to the use ofsaid ADCs in the treatment of diseases involving uPARAP expressingcells, such as certain cancers.

BACKGROUND

Urokinase-type Plasminogen Activator Receptor Associated Protein(uPARAP), also known as CD280, Endo180 and mannose receptor C type 2, isa member of the macrophage mannose receptor family of endocytictransmembrane glycoproteins. uPARAP is a membrane protein involved inmatrix turnover during tissue remodelling, particularly the uptake andintracellular degradation of collagen.

The receptor uPARAP is upregulated in the tumour cells of specificcancers, including sarcomas and late-stage glioblastoma. Additionally,the receptor is most often upregulated in stromal cells surroundingsolid tumours and some literature suggests a high expression of uPARAPin bone metastasis from prostate cancer (Caley et al., 2012, J. Pathol5: 775-783). In healthy adult individuals, the receptor displays arestricted expression pattern (Melander et al., 2015, Int J Oncol 47:1177-1188).

Antibody-drug conjugates (ADCs) are a new class of highly potentbiopharmaceutical drug designed as a targeted therapy, in particular forthe treatment of cancer. ADCs are complex molecules composed of anantibody (a whole mAb or an antibody fragment) linked, via a stable,chemical, linker that may possess labile bonds, to a biologically activedrug or cytotoxic compound. By combining the unique targetingcapabilities of antibodies with the cell-killing ability of cytotoxicdrugs, antibody-drug conjugates allow sensitive discrimination betweenhealthy and diseased tissue, based on expression of the antibodyantigen. This means that, in contrast to traditional chemotherapeuticagents, antibody-drug conjugates actively target and attack cancercells, so that healthy cells with little or no antigen expression areless severely affected.

To date, three ADCs have received market approval and several ADCs arecurrently in clinical trials.

WO 2010/111198 discloses conjugates comprising an anti-uPARAP antibodyand suggests use of such conjugates in the delivery of therapeuticagents to cells that express uPARAP.

Treatment methods currently exist for most cancer types. However, inmost cases with unsatisfactory efficiency or with detrimental sideeffects due to the lack of specificity of the treatment. Thus, there isa need for more efficient treatments with increased specificity.

SUMMARY

The present invention provides antibody-drug conjugates (ADCs) based onanti-uPARAP antibodies capable of binding to the N-terminal region ofthe uPARAP receptor. The ADCs as described herein are capable ofspecifically targeting cells and tissues expressing uPARAP, and haveexcellent in vitro and in vivo efficacy with no registered side effects.

In particular, the present disclosure relates to an antibody-drugconjugate comprising:

a. an antibody or antigen-binding fragment thereof capable of bindingto:

-   -   i. the amino acid sequence of SEQ ID NO: 36 or 37        (CysR-FN-II-CTLD-1 domains of uPARAP),    -   ii. the amino acid sequence of SEQ ID NO: 38 or 39 (CysR-FN-II        domains of uPARAP),    -   iii. the amino acid sequence of SEQ ID NO: 40 or 41        (FN—II-CTLD-1 domains of uPARAP),    -   iv. the amino acid sequence of SEQ ID NO: 30 or 31 (the        cystein-rich domain (CysR) of uPARAP)    -   v. the amino acid sequence of SEQ ID NO: 32 or 33 (the        Fibronectin type II (FN-II) domain of uPARAP), and/or    -   vi. the amino acid sequence of SEQ ID NO: 34 or 35 (the C-type        lectin-like domain 1 (CTLD 1) of uPARAP),

b. an active agent, and optionally

c. a linker which links a) to b).

Furthermore, the present disclosure relates to the use of the ADC asdefined above for the treatment of diseases and/or disorders involvingexpression of the uPARAP receptor.

DESCRIPTION OF DRAWINGS

FIG. 1. Schematic representation of the four protein family members ofthe Mannose receptor family, including uPARAP. All of the proteins havethe same over-all domain composition with an N-terminal signal peptidefollowed by a cysteine-rich domain, a fibronectin type II domain (FN-IIdomain), 8-10 C-type lectin-like domains (CTLDs), a transmembranespanning region and a small cytoplasmic tail (Adapted from Melander etal., 2015 Int J Oncology 47: 1177-1188).

FIG. 2. Schematic illustration of an uPARAP-directed ADC, in the form ofa targeting antibody, conjugated to amaleimidocaproyl-valine-citrulline-p-aminobenzoyloxycarbonyl-monomethylauristatin E (MC—VC-PAB-MMAE) linker-toxin construct. The targetingantibody is specific against the receptor uPARAP, which is found to behighly expressed in certain cancer types. The linker-toxin construct isattached by maleimide chemistry to thiols of free cysteines or reducedinterchain disulphide bridges (N=1-10 toxins per antibody). Thevaline-citrulline linker region with the peptide/amide bond to thespacer entity is a substrate for lysosomal proteases such as cathepsinB, but is sufficiently stable in the extracellular environment to ensurerelease of the conjugated drug only when taken up by cells expressingthe target antigen. The conjugated drug is a highly potent tubulininhibitor in the form of monomethyl auristatin E (MMAE). As a unit(mAb-vc-MMAE), this ADC construct ensures specific delivery of the drugcomponent only to cells expressing the uPARAP antigen, as well asintracellular release of the conjugated drug in these cells.

FIG. 3: Cellular uptake of mAb 2h9, labeled with a fluorophore(AlexaFluor 647, AF647) using a method similar to the conjugationprocedure described in the figure legend to FIG. 2 (partial reductionfollowed by reaction with a maleimide-derivatized AlexaFluor 647reagent), in uPARAP-positive cell lines, measured by flow cytometry.MFI: Mean fluorescence intensity. Specificity ratio: Ratio of2h9-AF647/aTNP-AF647 signals, with aTNP being a non-targeted controlmAb. These numbers demonstrate a specific uptake of 2h9-AF647, andconfirm that mAb 2h9 is taken up by uPARAP-positive cells following sucha conjugation method.

FIG. 4: A. Reducing SDS-PAGE of a targeting antibody (2h9), amAb-vc-MMAE ADC with a moderate drug-to-antibody ratio (DAR) of ˜4-5,and a mAb-vc-MMAE ADC with a DAR of ˜8-10. It is seen that conjugatedmAbs display reduced mobility in the gel, and that moderately conjugatedADC species are preferably conjugated via the mAb heavy chains, whereasthe ADC with a higher DAR is conjugated via both the heavy- and thelight chains. B. Reducing SDS-PAGE showing that incubation of ADCs withactivated recombinant cathepsin B (+rh cathepsin B) reverts ADC gelmobility back to that of unmodified targeting antibody, and thus thatthe linker region is indeed cleavable by lysosomal proteases such ascathepsin B. C. ELISA analysis showing retained affinity of mAb 2h9towards uPARAP following the reduction step of the conjugationprocedure, as well as in ADC form. Altogether, these data show that ADC2h9-vc-MMAE behaves as expected, in relation to gel mobility andaffinity towards the target receptor following conjugation.

FIG. 5: In vitro cell viability assays, based on exposure to the ADCs ina dilution series. The dilution series starts at 10 μg/mL ADC (mAbcomponent). followed by a series of 4-fold dilutions of the ADCs. Cellswere incubated for 72 hours, before being analyzed by colorimetricviability assay. Here, the assay shows a specific reduction in overallviability following incubation with uPARAP-directed ADC 2h9-vc-MMAE, incomparison to a non-targeted ADC (aTNP-vc-MMAE), in four cell linesexpressing the target receptor (U937, THP-1, HT1080 and KNS42 cells),whereas a receptor-negative cell line (CHO-K1) remains unaffected. Thisdemonstrates a receptor-specific reduction in the viability ofuPARAP-positive cell lines, following incubation with ADC 2h9-vc-MMAE.

FIG. 6: Cell cycle distribution analysis of four uPARAP-positive celllines (U937, THP-1, HT1080 or KNS42) following a 3-day incubation in thepresence of 1 μg/mL of uPARAP-directed ADC 2h9-vc-MMAE or control ADCaTNP-vc-MMAE, or 50 nM free MMAE toxin. Since MMAE is a tubulininhibitor, a drug effect may lead to an increase in the fraction ofcells in either the Sub-G1 phase (ultimately leading to apoptosis), orthe G2-M phase (inhibition of genomic segregation following DNAreplication). A dash indicates a cell count too low to register, due towidespread cell death and disintegration. It is seen that all four celllines display specific sensitivity towards uPARAP-directed ADC2h9-vc-MMAE (and free MMAE), evident from the shift in cell cycledistribution towards the Sub-G1 and G2/M phases in these samples.

FIG. 7: Competition assay, showing U937 cells being incubated for 3 daysin the presence of 1 μg/mL of uPARAP-directed ADC 2h9-vc-MMAE, in thesimultaneous presence of different concentrations of unconjugatedtargeting antibody (2h9), another antibody targeting uPARAP (5f4), orthe non-targeting control antibody (aTNP). It is seen that only a molarsurplus (1+μg/mL competing mAb) of non-conjugated targeting antibody 2h9can compete for the effect of the ADC, thereby rescuing cells from ADCmediated cell death. Thereby, the interaction between uPARAP and thetargeting antibody 2h9 is shown to be crucial for the observed cytotoxiceffect.

FIG. 8: It is shown that pre-incubating U937 cells in the presence of abroad-spectrum inhibitor of lysosomal proteases (E64D) leads to acomplete abrogation of the cytotoxic effect of uPARAP-directed ADC2h9-vc-MMAE. Thereby, lysosomal release of the conjugated drug is shownto be crucial for obtaining a cytotoxic effect.

FIG. 9: In vivo testing of the efficacy of uPARAP-directed ADC2h9-vc-MMAE in combating a uPARAP-positive, subcutaneous xenografttumour, established by injection of the cell line U937 in CB17 SCIDmice. The mice are treated by subcutaneous (s.c.) injection near thetumour with either uPARAP-directed ADC 2h9-vc-MMAE (N=10), control ADCaTNP-vc-MMAE (N=9), unconjugated mAb 2h9 (N=5), or a saline solution(PBS, N=5). All treatments are done in doses of 3 mg/kg/injection mAbcomponent, as 4 doses total, given every 4 days. Day 0 marks the day offirst injection, initiated once the tumour has reached a palpable sizeof 50-100 mm³, and the graph shows the average tumour size across eachtreatment group. It is seen that treatment with ADC 2h9-vc-MMAE resultsin a drastic decrease in tumour growth, whereas all other treatmentgroups reach a point of sacrifice within 10-12 days after startingtreatment. This demonstrates that uPARAP-directed ADC 2h9-vc-MMAE isefficient at inhibiting growth of a pre-established uPARAP-positivetumour in vivo. Furthermore, the data from the 2h9-vc-MMAE treated grouprepresent a permanent cure rate of 50% (see also FIG. 10).

FIG. 10: A more detailed look at the tumour growth of the 2h9-vc-MMAEtreated group described in FIG. 9, showing that this group included micesuffering from non-complete treatment and tumour relapse, as well asmice that lost the tumour burden completely and showed no tumourrelapse. Of the 10 mice treated with 2h9-vc-MMAE, 5 showed an almostimmediate relapse of tumour growth following treatment, quickly reachinga point of sacrifice, whereas the remaining 5 mice lost all signs of thetumour, and remained free from tumour growth for a period of 90 days,giving an overall permanent cure rate of 50% for 2h9-vc-MMAE treatedmice following s.c. administration.

FIG. 11: In vivo testing of the efficacy of uPARAP-directed ADC2h9-vc-MMAE in combating a uPARAP-positive, subcutaneous xenografttumour, established by injection of the cell line U937 in CB17 SCIDmice. The mice are treated by intravenous (i.v.) injection via the tailveins, with either uPARAP-directed ADC 2h9-vc-MMAE (N=10), control ADCaTNP-vc-MMAE (N=10), unconjugated mAb 2h9 (N=5), or a saline solution(PBS, N=5). All treatments are done in doses of 5 mg/kg/injection mAbcomponent, as 3 doses total, given every 4 days. Day 0 marks the day offirst injection, once the tumour has reached a palpable size of 50-100mm³, and the graph shows the average tumour size across each treatmentgroup. Under these conditions, treatment with uPARAP-directed ADC2h9-vc-MMAE results in a complete abrogation of the tumour burden in all10 mice, giving an overall permanent cure rate of 100% of the micefollowing intravenous administration of this ADC, further demonstratingthe efficacy of ADC 2h9-vc-MMAE in combating solid uPARAP-positivetumours.

FIG. 12: In vitro cell viability assays showing a specific reduction inoverall viability following incubation with either uPARAP-directed ADC2h9-vc-MMAE or uPARAP-directed ADC 5f4-vc-MMAE, in comparison to anon-targeted ADC (aTNP-vc-MMAE), in the U937 cell line. The dataindicates that ADCs based on 5f4 have comparable efficacy to ADCs basedon the 2h9 antibody.

FIG. 13: Immunohistochemistry staining of different sarcomas(liposarcoma, myxofibrosarcoma, dermatofibrosarcoma protuberans (DFSP)and leiomyosarcoma (LMS). The staining method shows tissue expression ofuPARAP as a dark reddish-brown color. Expression of uPARAP is evident insections of malignant cancer (tumor) tissue, whereas sections ofnon-cancer tissue are devoid of uPARAP, demonstrating the increasedexpression levels of uPARAP, found in sarcomas. Scale bars: 20 μm.

FIG. 14: Different antibodies directed against the N-terminal part ofuPARAP can be utilized for efficient drug delivery in an ADC format.ADCs with the composition mAb-vc-MMAE were prepared as described in thelegend to FIG. 2, using three different antibodies directed againstepitopes within the three N-terminal domains of uPARAP (mAb 2h9, mAb 5f4and mAb 967). For comparison, an ADC was prepared in the same manner butusing an anti-uPARAP antibody directed against an epitope outside theN-terminal three domains (mAb 11c9). In vitro cell viability assays withU937 cells were then performed as described in the legend to FIG. 5,using all of these ADCs. All ADCs lead to a specific reduction inoverall cell viability but with the cellular sensitivity to 2h9-vc-MMAE,5f4-vc-MMAE and 967-vc-MMAE being higher than the sensitivity to11c9-vc-MMAE.

FIG. 15: Different toxins can be used in an ADC format targeting theN-terminal part of uPARAP. ADCs with mAb 2h9 as the antibody componentwere prepared as described in the legend to FIG. 2 but using thefollowing linker-cytotoxin units instead of VC-PAB-MMAE: VC-PAB-MMAF(with MMAF being monomethyl auristatin F, a carboxyl-variant of MMAE)and PEG4-va-PBD (with PEG4 referring to a polyethylenglycol spacer, vabeing valine-alanine and PBD referring to a dimericpyrrolobenzodiazepine). The resulting ADCs (referred to as 2h9-vc-MMAFand 2h9-va-PBD respectively) were used for in vitro cell viabilityassays with U937 cells, performed as described in the legend to FIG. 5.U937 cells displayed very strong sensitivity to 2h9-vc-MMAF and a moremoderate sensitivity to 2h9-va-PBD.

FIG. 16: An ADC with mAb 2h9 as the antibody component was prepared asdescribed in the legend to FIG. 2 but using the followinglinker-cytotoxin unit instead of VC-PAB-MMAE: PEG4-vc-Duocarmycin SA(with PEG4 referring to a polyethylenglycol spacer and vc beingvaline-citrulline). The resulting ADC (referred to as 2h9-vc-DuocSA) wasused for in vitro cell viability assays with U937 cells, performed asdescribed in the legend to FIG. 5. U937 cells displayed a low butmeasurable sensitivity to 2h9-vc-DuocSA.

FIG. 17: ADCs with mAbs 2h9 or aTNP as the antibody component wereprepared as described in the legend to FIG. 2, using the followinglinker-cytotoxin units: VC-PAB-MMAE or VC-PAB-MMAF. The resulting ADCs(referred to as 2h9-vc-MMAE, 2h9-vc-MMAF, aTNP-vc-MMAE and aTNP-vc-MMAF)were used for in vitro cell viability assays using human glioblastomaexplants cells and performed as described in the legend to FIG. 5. Theseglioblastoma explant cells showed a high degree of specific sensitivitytowards uPARAP-directed ADCs, based on both the MMAE and the MMAF toxin.

FIG. 18: A recombinant mAb 2h9 product, designated “2h9 cloned”, wasproduced in CHO cells transfected with an expression vector includingthe DNA sequences encoding the light and the heavy chain of mAb 2h9([SEQ ID NO: 1] and [SEQ ID NO: 5], respectively). The reactivity ofthis product was analyzed in Western blotting and compared with mAb 2h9produced by hybridoma cell culture (“2h9 original”). For Westernblotting, a detergent cell lysate prepared from uPARAP-positive MG63human osteosarcoma cells was analyzed, using identical concentrations of“2h9 cloned” and “2h9 original” as the primary antibodies. The twoantibody products display identical reaction and both react specificallywith the uPARAP protein. No reaction is seen in the absence of primaryantibody (negative control).

Sequences

SEQ ID NO Description SEQ ID NO: 1 mAb 2h9 Light Chain full length aminoacid sequence SEQ ID NO: 2 mAb 2h9 Light Chain full length CDR1 SEQ IDNO: 3 mAb 2h9 Light Chain full length CDR2 SEQ ID NO: 4 mAb 2h9 LightChain full length CDR3 SEQ ID NO: 5 mAb 2h9 Heavy Chain full lengthamino acid sequence SEQ ID NO: 6 mAb 2h9 Heavy Chain full length CDR1SEQ ID NO: 7 mAb 2h9 Heavy Chain full length CDR2 SEQ ID NO: 8 mAb 2h9Heavy Chain full length CDR3 SEQ ID NO: 9 Fab 2h9 Light Chain amino acidsequence 1-214 SEQ ID NO: 10 Fab 2h9 Heavy Chain amino acid sequence1-224 SEQ ID NO: 11 mAb 5f4 Light Chain variable (VL) region amino acidsequence SEQ ID NO: 12 mAb 5f4 Light Chain variable (VL) region CDR1 SEQID NO: 13 mAb 5f4 Light Chain variable (VL) region CDR2 SEQ ID NO: 14mAb 5f4 Light Chain variable (VL) region CDR3 SEQ ID NO: 15 mAb 5f4Heavy Chain variable (VH) region amino acid sequence SEQ ID NO: 16 mAb5f4 Heavy Chain variable (VL) region CDR1 SEQ ID NO: 17 mAb 5f4 HeavyChain variable (VL) region CDR2 SEQ ID NO: 18 mAb 5f4 Heavy Chainvariable (VL) region CDR3 SEQ ID NO: 19 Fab 9b7 Light Chain amino acidsequence 1-214 SEQ ID NO: 20 Fab 9b7 Light Chain amino acid sequence8-214 SEQ ID NO: 21 Fab 9b7 Light Chain CDR1 SEQ ID NO: 22 Fab 9b7 LightChain CDR2 SEQ ID NO: 23 Fab 9b7 Light Chain CDR3 SEQ ID NO: 24 Fab 9b7Heavy Chain amino acid sequence 1-221 SEQ ID NO: 25 Fab 9b7 Heavy Chainamino acid sequence 9-221 SEQ ID NO: 26 Fab 9b7 Heavy Chain CDR1 SEQ IDNO: 27 Fab 9b7 Heavy Chain CDR2 SEQ ID NO: 28 Fab 9b7 Heavy Chain CDR3SEQ ID NO: 29 Human uPARAP full length sequence (GenBank: AAI53885.1)SEQ ID NO: 30 CysR domain as listed by NCBI (amino acids (aa) 46-161 offull length human uPARAP) SEQ ID NO: 31 CysR domain as predicted by theSMART tool (simple modular architecture research tool) at EMBL(http://smart.embl-heidelberg.de/) {Schultz et al. Proc. Natl. Acad.Sci. USA, Vol. 95, pp. 5857-5864, May 1998} (amino acids (aa) 41-161 offull length human uPARAP) SEQ ID NO: 32 FN-II domain as listed by NCBI(aa 181-228 of full length Human uPARAP) SEQ ID NO: 33 FN-II domain aspredicted by SMART (aa 180-228 of full length Human uPARAP) SEQ ID NO:34 CTLD-1 domain as listed by NCBI (aa 247-361 of full length HumanuPARAP) SEQ ID NO: 35 CTLD-1 domain as predicted by SMART (aa 235-360 offull length Human uPARAP) SEQ ID NO: 36 CysR-FN-II-CTLD-1 as listed byNCBI (aa 46-361 of full length Human uPARAP) SEQ ID NO: 37CysR-FN-II-CTLD-1 as predicted by SMART (aa 41-360 of full length HumanuPARAP) SEQ ID NO: 38 CysR-FN-II as listed by NCBI (aa 46-228 of fulllength Human uPARAP) SEQ ID NO: 39 CysR-FN-II as predicted by SMART (aa41-228 of full length Human uPARAP) SEQ ID NO: 40 FN-II-CTLD-1 as listedby NCBI (aa 181-361 of full length Human uPARAP) SEQ ID NO: 41FN-II-CTLD-1 as predicted by SMART (aa 180-360 of full length HumanuPARAP) SEQ ID NO: 42 mAb 2h9 Light Chain Paratome-predicted ABR1 SEQ IDNO: 43 mAb 2h9 Light Chain Paratome-predicted ABR2 SEQ ID NO: 44 mAb 2h9Light Chain Paratome-predicted ABR3 SEQ ID NO: 45 mAb 2h9 Heavy ChainParatome-predicted ABR1 SEQ ID NO: 46 mAb 2h9 Heavy ChainParatome-predicted ABR2 SEQ ID NO: 47 mAb 2h9 Heavy ChainParatome-predicted ABR3 SEQ ID NO: 48 mAb 5f4 Light ChainParatome-predicted ABR1 SEQ ID NO: 49 mAb 5f4 Light ChainParatome-predicted ABR2 SEQ ID NO: 50 mAb 5f4 Light ChainParatome-predicted ABR3 SEQ ID NO: 51 mAb 5f4 Heavy ChainParatome-predicted ABR1 SEQ ID NO: 52 mAb 5f4 Heavy ChainParatome-predicted ABR2 SEQ ID NO: 53 mAb 5f4 Heavy ChainParatome-predicted ABR3 SEQ ID NO: 54 mAb 9b7 Light ChainParatome-predicted ABR1 SEQ ID NO: 55 mAb 9b7 Light ChainParatome-predicted ABR2 SEQ ID NO: 56 mAb 9b7 Light ChainParatome-predicted ABR3 SEQ ID NO: 57 mAb 9b7 Heavy ChainParatome-predicted ABR1 SEQ ID NO: 58 mAb 9b7 Heavy ChainParatome-predicted ABR2 SEQ ID NO: 59 mAb 9b7 Heavy ChainParatome-predicted ABR3

Complementarity Determining Regions (CDRs) were predicted according tothe definition scheme of Kabat et al. as specified in the referencesKabat et al. (1983), Kabat et al. (1991) and Wu and Kabat (2008) using acomputerized Kabat-numbering programme as published by Dunbar and Deane(2016). Antigen binding regions (ABRs) according to the Paratomealgorithm were also predicted as specified in the references Kunik etal. (2012a and b). The ABRs represent alternative CDRs of the antibodiesdisclosed herein.

Complete regions involved in antigen recognition and binding may deviateslightly from the specified CDRs and ABRs and all sequence data includedin the variable regions or Fab fragments specified here are covered aspotentially contributing to antigen binding. Methods or algorithmsdifferent from those employed here may be used for identification ofpotential binding/recognition regions. Therefore, in addition to thepredicted CDRs as presented herein, this invention covers any amino acidsequences predicted to represent CDRs or ABRs in mAbs 2h9, 5f4 and 967based on the respective Fab regions and variable regions (SEQ ID NOs: 9,10, 11, 15, 20 and 25, respectively), using such methods or algorithms.Examples of additional methods and algorithms for the prediction of CDRsinclude, but are not limited to, the IMGT system (LeFranc et al.,(2003)).

Due to the position of primer regions during sequencing of the Fab 9B7light and heavy chains some ambiguity is expected in the N-terminalregion of these sequences. Thus, the first 7 amino acids of SEQ ID NO:19 may not be exact. The same goes for amino acids 1-8 of SEQ ID NO: 24.SEQ ID NOs: 20 and 25 correspond to SEQ ID NOs: 19 and 24 respectivelywithout the ambiguous N-terminal amino acids.

DETAILED DESCRIPTION

The antibody-drug conjugate targeting uPARAP of the present disclosurecomprises

-   -   a) an antibody capable of binding to the cystein-rich domain        (CysR), the Fibronectin type II (FN-II) domain and/or to the        C-type lectin-like domain 1 (CTLD 1) of uPARAP,    -   b) an active agent, and    -   c) optionally a linker which links a) to b).

In a particular aspect, the antibody-drug conjugate targeting uPARAP ofthe present disclosure comprises

a. an antibody or antigen-binding fragment thereof capable of bindingto:

-   -   i. the amino acid sequence of SEQ ID NO: 36 or 37        (CysR-FN-II-CTLD-1 domains of uPARAP),    -   ii. the amino acid sequence of SEQ ID NO: 38 or 39 (CysR-FN-II        domains of uPARAP),    -   iii. the amino acid sequence of SEQ ID NO: 40 or 41        (FN—II-CTLD-1 domains of uPARAP),    -   iv. the amino acid sequence of SEQ ID NO: 30 or 31 (the        cystein-rich domain (CysR) of uPARAP)    -   v. the amino acid sequence of SEQ ID NO: 32 or 33 (the        Fibronectin type II (FN-II) domain of uPARAP), and/or    -   vi. the amino acid sequence of SEQ ID NO: 34 or 35 (the C-type        lectin-like domain 1 (CTLD 1) of uPARAP),

b. an active agent, and optionally

c. a linker which links a) to b).

Antibody Directed Against uPARAP

The anti-uPARAP antibody of the present disclosure is internalised uponbinding to uPARAP at the cell surface, thus allowing for intracellularactions of the active agent of the ADC complex. It is known from e.g. WO2010/111198 that not all antibodies capable of binding to uPARAP areinternalised at the same rate or in the same amount. Indeed, someanti-uPARAP antibodies are not internalised at all and are therefore notsuitable for use in ADCs.

The uPARAP receptor consists of an N-terminal cysteine-rich domain(CysR), a fibronectin type II (FN-II) domain, and eight C-typelectin-like domains (CTLDs 1-8), cf. FIG. 1. Short amino acid sequencesconnect the individual domains. The data presented herein suggests thatanti-uPARAP antibodies targeting the three most N-terminal domains ofuPARAP are very efficient for use in ADCs.

Thus, the anti-uPARAP antibody of the present disclosure preferablybinds to the N-terminal region of uPARAP, more preferably to an epitopelocated in the three most N-terminal domains of uPARAP, that is thecystein-rich domain, the fibronectin type II domain and/or C-typelectin-like domain 1, including the linker sequences connecting thesedomains of uPARAP.

Thus, the anti-uPARAP antibody of the present disclosure is capable ofbinding to a peptide comprising or consisting of the cystein-rich domain(CysR) (SEQ ID NO: 30 or 31), the fibronectin type II (FN-II) domain(SEQ ID NO: 32 or 33) and/or to the C-type lectin-like domain 1 (CTLD 1)(SEQ ID NO: 34 or 35) of uPARAP.

The cystein-rich domain, the fibronectin type II domain and the C-typelectin-like domain 1 including the linker sequences connecting thesedomains as listed by NCBI correspond to aa 46-361 of full length humanuPARAP. Thus, in one embodiment the epitope for the anti-uPARAP antibodyis located in aa 46-361 of SEQ ID NO: 29 (full length human uPARAP). Inone embodiment, the anti-uPARAP antibody of the present disclosure bindsto an epitope located in aa 31-365 of SEQ ID NO: 29, more preferably inaa 46-361 of SEQ ID NO: 29, corresponding to SEQ ID NO: 36 herein. SMARTpredicts CYSR-FN-II-CTLD1 including the linker sequences connectingthese domains to aa 41-360 of SEQ ID NO: 29. Thus, in one embodiment theepitope for the anti-uPARAP antibody is located in aa 41-360 of SEQ IDNO: 29, corresponding to SEQ ID NO: 37 herein.

In one embodiment, the anti-uPARAP antibody of the present disclosurebinds to the CysR domain and/or the CTLD-1 domain.

In one embodiment, the anti-uPARAP antibody of the present disclosurebinds to the CysR domain, which is predicted by NCBI to consist of aa46-161 of full length Human uPARAP, corresponding to SEQ ID NO: 30herein, and by SMART to consist of aa 41-161 of full length HumanuPARAP, corresponding to SEQ ID NO: 31 herein. I.e. in one embodiment itbinds to an epitope located in aa 46-161 or 41-161 of SEQ ID NO: 29.

In one embodiment, the anti-uPARAP antibody of the present disclosurebinds to the FN-II domain, which is predicted by NCBI to consist of aa181-228 of full length Human uPARAP, corresponding to SEQ ID NO: 32herein, and by SMART to consist of aa 180-228 of full length HumanuPARAP, corresponding to SEQ ID NO: 33 herein. I.e. in one embodiment itbinds to an epitope located in aa 181-228 or 180-228 of SEQ ID NO: 29.

In one embodiment, the anti-uPARAP antibody of the present disclosurebinds to the CTLD-1 domain which is predicted by NCBI to consist of aa247-361 of full length

Human uPARAP, corresponding to SEQ ID NO: 34 herein, and by SMART toconsist of aa 235-360 of full length human uPARAP, corresponding to SEQID NO: 35 herein. I.e. in one embodiment it binds to an epitope locatedin aa 247-361 or 235-360 of SEQ ID NO: 29.

In one embodiment, the anti-uPARAP antibody of the present disclosure iscapable of binding to a peptide comprising or consisting of the CysR andFN-II domain including the linker sequences connecting these domains,which is predicted by NCBI to consist of aa 46-228 of full length humanuPARAP, corresponding to SEQ ID NO: 38, and by SMART to consist of aa41-228 of full length human uPARAP, corresponding to SEQ ID NO: 39herein. I.e. in one embodiment it binds to an epitope located in aa46-228 or 41-228 of SEQ ID NO: 29.

In one embodiment, the anti-uPARAP antibody of the present disclosure iscapable of binding to a peptide comprising or consisting of the FN-IIand CTLD-1 domain including the linker sequences connecting thesedomains, which is predicted by NCBI to consist of aa 181-361 of fulllength human uPARAP, corresponding to SEQ ID NO: 40 herein, and by SMARTto consist of aa 180-360 of full length human uPARAP, corresponding toSEQ ID NO: 41 herein. I.e. in one embodiment it binds to an epitopelocated in aa 180-361 or 181-360 of SEQ ID NO: 29.

In one embodiment the anti-uPARAP antibody of the present disclosure isthe mouse monoclonal IgG1κ antibody of clone 2.h.9:F12 commerciallyavailable from Merck Millipore(http://www.merckmillipore.com/DK/en/product/Anti-UPAR-Associated-Protein-Antibody%2C-clone-2.h.9%3AF12.MM_NF-MAB2613?cid=BI-XX-BRC-P-GOOG-ANTI-B302-1075)or a functional fragment or variant thereof, such as a chimeric orhumanised version thereof. Mouse monoclonal IgG1κ antibody clone2.h.9:F12 is referred to herein as the “2h9” antibody or “mAb 2h9”. The2h9 antibody reacts with both human and mouse uPARAP and is thereforewell suited for both preclinical and clinical studies.

Previous studies indicate that the epitope for the 2h9 antibody islocated in the three most N-terminal domains of uPARAP, particularly inthe CysR domain or the CTLD-1 domain. A soluble recombinant proteinconsisting of the three n-terminal domains of uPARAP (CysR, FN—II andCTLD-1) binds to immobilized 2h9 in a BIAcore setup, limiting thelocation of binding by mAb 2h9 to these three n-terminal domains(Jurgensen et al., 2011, JBC 286(37):32736-48). Furthermore, swappingthe FN-II domain of uPARAP with the FN-II domain of other members of thesame receptor family has no effect on binding of mAb 2h9, suggestingthat the FN-II domain does not likely contain the epitope for mAb 2h9(Jurgensen et al., 2014, JBC 289(11):7935-47). This effectively limitsbinding of mAb 2h9 to either the CysR domain, or the CTLD-1 domain.

The predicted CDRs of immunoglobulin light chain variable region of mAb2h9 correspond to SEQ ID NOs: 2-4 and the predicted CDRs ofimmunoglobulin heavy chain variable region of mAb 2h9 correspond to SEQID NOs: 6-8.

In one embodiment the anti-uPARAP antibody of the present disclosure isan antibody corresponding to the 2h9 antibody or a functional fragmentor variant thereof selected from the group consisting of:

a. an antibody or antigen-binding fragment thereof comprising

-   -   i. an immunoglobulin light chain variable region comprising or        consisting of the amino acid sequence of SEQ ID NO: 1 or 9 or a        sequence having at least 70% sequence identity thereto, such as        at least 80% sequence identity thereto, for example at least 90%        sequence identity thereto, and/or    -   ii. an immunoglobulin heavy chain variable region comprising or        consisting of the amino acid sequence of SEQ ID NO: 5 or 10 or a        sequence having at least 70% sequence identity thereto, such as        at least 80% sequence identity thereto, for example at least 90%        sequence identity thereto,

b. an antibody or antigen-binding fragment thereof that binds to thesame epitope as the antibody of a),

c. a humanised version of the antibody or antigen-binding fragmentthereof of a), or a humanised version of the antibody or antigen-bindingfragment thereof of b),

d. a chimeric version of the antibody or antigen-binding fragmentthereof of a), or a chimeric version of the antibody or antigen-bindingfragment thereof of b),

e. an antibody or antigen-binding fragment thereof comprising

-   -   i. one or more of the amino acid sequences of SEQ ID NOs: 2, 3,        4, 6, 7 and 8, or    -   ii. the amino acid sequences of SEQ ID NOs: 2, 3 and 4, and/or        the amino acid sequences of SEQ ID NOs 6, 7 and 8,

f. an antibody or antigen-binding fragment thereof comprising

-   -   i. one or more of the amino acid sequences of SEQ ID Nos: 42,        43, 44, 45, 46 and 47, or    -   ii. the amino acid sequences of SEQ ID NOs: 42, 43 and 44,        and/or the amino acid sequences of SEQ ID NOs 45, 46 and 47.

To preserve antigen recognition of the antibodies disclosed herein thesequence variance is usually not in the CDRs or ABRs. Thus, in apreferred embodiment, any sequence variation is located outside the CDRsor ABRs. All variant antibodies and antigen binding fragments disclosedherein retain the capability to bind to uPARAP.

For example, the antibody of the present disclosure may comprise

a. an immunoglobulin light chain variable region comprising the aminoacid sequence of SEQ ID NO: 1 or 9 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. a CDR1 having an aa sequence according to SEQ ID NO: 2,    -   ii. a CDR2 having an aa sequence according to SEQ ID NO: 3,    -   iii. a CDR3 having an aa sequence according to SEQ ID NO: 4, and

b. an immunoglobulin heavy chain variable region comprising the aminoacid sequence of SEQ ID NO: 5 or 10 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. a CDR1 having an aa sequence according to SEQ ID NO: 6,    -   ii. a CDR2 having an aa sequence according to SEQ ID NO: 7,    -   iii. a CDR3 having an aa sequence according to SEQ ID NO: 8,        wherein any sequence variance is outside the CDRs.

Alternatively, the antibody of the present disclosure may comprise

a. an immunoglobulin light chain variable region comprising the aminoacid sequence of SEQ ID NO: 1 or 9 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. an ABR1 having an aa sequence according to SEQ ID NO: 42,    -   ii. an ABR 2 having an aa sequence according to SEQ ID NO: 43,    -   iii. an ABR 3 having an aa sequence according to SEQ ID NO: 44,        and

b. an immunoglobulin heavy chain variable region comprising the aminoacid sequence of SEQ ID NO: 5 or 10 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. an ABR 1 having an aa sequence according to SEQ ID NO: 45,    -   ii. an ABR 2 having an aa sequence according to SEQ ID NO: 46,    -   iii. an ABR 3 having an aa sequence according to SEQ ID NO: 47,        wherein any sequence variance is outside the ABRs.

In one embodiment the anti-uPARAP antibody of the present disclosure isthe mouse monoclonal antibody 5f4 or a functional fragment or variantthereof. The 5f4 antibody is IgG1κ.

Studies have shown that the epitope for 5f4 is located in the FN-IIdomain of uPARAP. In Jurgensen et al., 2014 it is shown that the 5f4antibody is capable of binding to wildtype uPARAP and to artificialmembers of the mannose receptor family, where the wildtype FN-II domainhas been switched with that of uPARAP. 5f4 is not capable of binding tothe other members of the mannose receptor family proteins in theirwildtype form, or with uPARAP where the wildtype FN-II domain has beenswitched with equivalent domains from the other members of the mannosereceptor family (Jurgensen et al., 2014, JBC 289(11):7935-47).

In one embodiment the anti-uPARAP antibody of the present disclosure isan antibody corresponding to the 5f4 antibody or a functional fragmentor variant thereof selected from the group consisting of

a. an antibody or antigen-binding fragment thereof comprising

-   -   i. an immunoglobulin light chain variable region comprising or        consisting of the amino acid sequence of SEQ ID NO: 11 or a        sequence having at least 70% sequence identity thereto, such as        at least 80% sequence identity thereto, for example at least 90%        sequence identity thereto, and/or    -   ii. an immunoglobulin heavy chain variable region comprising or        consisting of the amino acid sequence of SEQ ID NO: 15 or a        sequence having at least 70% sequence identity thereto, such as        at least 80% sequence identity thereto, for example at least 90%        sequence identity thereto,

b. an antibody or antigen-binding fragment thereof that binds to thesame epitope as the antibody of a),

c. a humanised version of the antibody or antigen-binding fragmentthereof of a), or a humanised version of the antibody or antigen-bindingfragment thereof of b),

d. a chimeric version of the antibody or antigen-binding fragmentthereof of a), or a chimeric version of the antibody or antigen-bindingfragment thereof of b),

e. an antibody or antigen-binding fragment thereof comprising

-   -   i. one or more of the amino acid sequences of SEQ ID NOs: 12,        13, 14, 16, 17 and 18, or    -   ii. the amino acid sequences of SEQ ID NOs: 12, 13 and 14,        and/or the amino acid sequences of SEQ ID NOs 16, 17 and 18.

f. an antibody or antigen-binding fragment thereof comprising

-   -   i. one or more of the amino acid sequences of SEQ ID NOs: 48,        49, 50, 51, 52 and 53, or    -   ii. the amino acid sequences of SEQ ID NOs: 48, 49 and 50,        and/or the amino acid sequences of SEQ ID NOs 51, 52 and

To allow for some sequence variance outside the CDRs, the antibody ofthe present disclosure may comprise

a. an immunoglobulin light chain variable region comprising the aminoacid sequence of SEQ ID NO: 11 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. a CDR1 having an aa sequence according to SEQ ID NO: 12,    -   ii. a CDR2 having an aa sequence according to SEQ ID NO: 13,    -   iii. a CDR3 having an aa sequence according to SEQ ID NO: 14,        and

b. an immunoglobulin heavy chain variable region comprising the aminoacid sequence of SEQ ID NO: 15 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. a CDR1 having an aa sequence according to SEQ ID NO: 16,    -   ii. a CDR2 having an aa sequence according to SEQ ID NO: 17,    -   iii. a CDR3 having an aa sequence according to SEQ ID NO: 18,        wherein any sequence variance is outside the CDRs.

Alternatively, the antibody of the present disclosure may comprise

a. an immunoglobulin light chain variable region comprising the aminoacid sequence of SEQ ID NO: 11 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. an ABR1 having an aa sequence according to SEQ ID NO: 48,    -   ii. an ABR 2 having an aa sequence according to SEQ ID NO: 49,    -   iii. an ABR 3 having an aa sequence according to SEQ ID NO: 49,        and

b. an immunoglobulin heavy chain variable region comprising the aminoacid sequence of SEQ ID NO: 15 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. an ABR 1 having an aa sequence according to SEQ ID NO: 51,    -   ii. an ABR 2 having an aa sequence according to SEQ ID NO: 52,    -   iii. an ABR 3 having an aa sequence according to SEQ ID NO: 53,        wherein any sequence variance is outside the ABRs.

In one embodiment the anti-uPARAP antibody of the present disclosure isthe mouse monoclonal antibody 967 (mAb 967) or a functional fragment orvariant thereof. Previous studies indicate that the epitope for the 967antibody is located in the three most N-terminal domains of uPARAP. Whena soluble recombinant protein consisting of the three N-terminal domainsof uPARAP (CysR, FN—II and CTLD-1) is immobilized in a BIAcore setup,mAb 967 binds to this construct.

In one embodiment the anti-uPARAP antibody is selected from the groupconsisting of

a. an antibody or antigen-binding fragment thereof comprising

-   -   i. an immunoglobulin light chain variable region comprising or        consisting of the amino acid sequence of SEQ ID NO: 19 or 20 or        a sequence having at least 70% sequence identity thereto, such        as at least 80% sequence identity thereto, for example at least        90% sequence identity thereto, and/or    -   ii. an immunoglobulin heavy chain variable region comprising or        consisting of the amino acid sequence of SEQ ID NO: 24 or 25 or        a sequence having at least 70% sequence identity thereto, such        as at least 80% sequence identity thereto, for example at least        90% sequence identity thereto,

b. an antibody or antigen-binding fragment thereof that binds to thesame epitope as the antibody of a),

c. a humanised version of the antibody or antigen-binding fragmentthereof of a), or a humanised version of the antibody or antigen-bindingfragment thereof of b),

d. a chimeric version of the antibody or antigen-binding fragmentthereof of a), or a chimeric version of the antibody or antigen-bindingfragment thereof of b),

e. an antibody or antigen-binding fragment thereof comprising

-   -   i. one or more of the amino acid sequences of SEQ ID NOs: 21,        22, 23, 26, 27 and 28, or    -   ii. the amino acid sequences of SEQ ID NOs: 21, 22 and 23,        and/or the amino acid sequences of SEQ ID NOs 26, 27 and 28.

f. an antibody or antigen-binding fragment thereof comprising

-   -   i. one or more of the amino acid sequences of SEQ ID NOs: 54,        55, 56, 57, 58 and 59, or    -   ii. the amino acid sequences of SEQ ID NOs: 54, 55 and 56,        and/or the amino acid sequences of SEQ ID NOs: 57, 58 and 59.

In one embodiment, the antibody of the present disclosure may comprise

a. an immunoglobulin light chain variable region comprising the aminoacid sequence of SEQ ID NO: 19 or 20 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. a CDR1 having an aa sequence according to SEQ ID NO: 21,    -   ii. a CDR2 having an aa sequence according to SEQ ID NO: 22,    -   iii. a CDR3 having an aa sequence according to SEQ ID NO: 23,        and

b. an immunoglobulin heavy chain variable region comprising the aminoacid sequence of SEQ ID NO: 24 or 25 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. a CDR1 having an aa sequence according to SEQ ID NO: 26,    -   ii. a CDR2 having an aa sequence according to SEQ ID NO: 27,    -   iii. a CDR3 having an aa sequence according to SEQ ID NO: 28,        wherein any sequence variance is outside the CDRs.

Alternatively, the antibody of the present disclosure may comprise

a. an immunoglobulin light chain variable region comprising the aminoacid sequence of SEQ ID NO: 19 or 20 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. an ABR1 having an aa sequence according to SEQ ID NO: 54,    -   ii. an ABR 2 having an aa sequence according to SEQ ID NO: 55,    -   iii. an ABR 3 having an aa sequence according to SEQ ID NO: 56,        and

b. an immunoglobulin heavy chain variable region comprising the aminoacid sequence of SEQ ID NO: 24 or 25 or a sequence having at least 70%sequence identity thereto, such as at least 80% sequence identitythereto, for example at least 90% sequence identity thereto, and furthercomprising

-   -   i. an ABR 1 having an aa sequence according to SEQ ID NO: 57,    -   ii. an ABR 2 having an aa sequence according to SEQ ID NO: 58,    -   iii. an ABR 3 having an aa sequence according to SEQ ID NO: 59,        wherein any sequence variance is outside the ABRs.

By “antibody” we include substantially intact antibody molecules,chimeric antibodies, humanised antibodies, human antibodies, singlechain antibodies, bispecific antibodies, antibody heavy chains, antibodylight chains, homodimers and heterodimers of antibody heavy and/or lightchains, and antigen-binding fragments and derivatives of the same.

By “antigen-binding fragment” we mean a functional fragment of anantibody that is capable of binding to uPARAP.

In one embodiment, the anti-uPARAP antibody according to the presentdisclosure is selected from a mouse antibody, a chimeric antibody, ahuman antibody, a humanised antibody, a humanised antigen-bindingfragment, a Fab fragment, a Fab′ fragment, a F(ab′)2 fragment, an Fvfragment, a single chain antibody (SCA) such as an scFv, the variableportion of the heavy and/or light chains thereof, or a Fab miniantibody,where these fragments or modified antibodies may be derived from mouse,chimeric, human or humanized antibodies.

In one embodiment the anti-uPARAP antibody is a humanised or fully humanmonoclonal antibody or antigen-binding fragment thereof.

In one embodiment, the anti-uPARAP antibody of the present disclosure isa recombinant antibody.

The anti-uPARAP antibody of the present disclosure may be of anyimmunoglobulin class including IgG, IgM, IgD, IgE, IgA, and any subclassthereof. IgG subclasses are also well known to those in the art andinclude but are not limited to human IgGI, IgG2, IgG3 and IgG4. In oneembodiment the antibody is an IgG monoclonal antibody. In one embodimentthe antibody is IgG1 κ.

In one embodiment the anti-uPARAP antibody is an antigen-bindingfragment.

The advantages of using antibody fragments, rather than wholeantibodies, are several-fold. The smaller size of the fragments may leadto improved pharmacological properties, such as better tissuepenetration. Moreover, antigen-binding fragments can be expressed in andsecreted from E. coli or other non-mammalian host cells, thus allowingthe facile production of large amounts of said fragments.

Fab is the fragment which contains a monovalent antigen-binding fragmentof an antibody molecule which can be produced by digestion of wholeantibody with the enzyme papain, or other specific means of proteolysisto yield a light chain and a portion of the heavy chain.

F(ab′)2 is the fragment of the antibody that can be obtained by treatingwhole antibody with the enzyme pepsin, or other specific means ofproteolysis to yield a bivalent antigen-binding fragment withoutsubsequent reduction; F(ab′)2 is a dimer of two Fab fragments heldtogether by two disulfide bonds.

Fv is a genetically engineered fragment containing the variable regionof the light chain and the variable region of the heavy chain, expressedas two chains.

Single chain antibody (SCA) is a genetically engineered moleculecontaining the variable region of the light chain and the variableregion of the heavy chain, linked by a suitable polypeptide linker as agenetically fused, single chain molecule, including an scFv.

Methods of generating antibodies and antibody fragments are well knownin the art. For example, antibodies may be generated via any one ofseveral methods which employ induction of in vivo production of antibodymolecules, screening of immunoglobulin libraries, or generation ofmonoclonal antibody molecules by cell lines in culture. These include,but are not limited to, the hybridoma technique, the human B-cellhybridoma technique, and the Epstein-Barr virus (EBV)-hybridomatechnique.

Likewise, antibody fragments can be obtained using methods well known inthe art. For example, antibody fragments according to the presentinvention can be prepared by proteolytic hydrolysis of the antibody withvarious enzymes or by expression in E. coli or mammalian cells (e.g.chinese hamster ovary cell culture or other protein expression systems)of DNA encoding the fragment. Alternatively, antibody fragments can beobtained by pepsin or papain digestion of whole antibodies byconventional methods.

It will be appreciated by persons skilled in the art that for humantherapy or diagnostics, human or humanised antibodies are preferablyused. Humanised forms of non-human (e.g. murine) antibodies aregenetically engineered chimeric antibodies or antibody fragments havingpreferably minimal-portions derived from non-human antibodies. Humanisedantibodies include antibodies in which complementary determining regions(CDRs) of a human antibody (recipient antibody) are replaced by residuesfrom a complementary determining region of a non-human species (donorantibody) such as mouse, rat of rabbit having the desired functionality.In some instances, Fv framework residues of the human antibody arereplaced by corresponding non-human residues. Humanised antibodies mayalso comprise residues which are found neither in the recipient antibodynor in the imported CDR or framework sequences. In general, thehumanised antibody will comprise substantially all of at least one, andtypically two, variable domains, in which all or substantially all ofthe complementarity determining regions correspond to those of anon-human antibody and all, or substantially all, of the frameworkregions correspond to those of a relevant human consensus sequence.Humanised antibodies optimally also include at least a portion of anantibody constant region, such as an Fc region, typically derived from ahuman antibody.

Methods for humanising non-human antibodies are well known in the art.Generally, the humanised antibody has one or more amino acid residuesintroduced into it from a source which is non-human. These non-humanamino acid residues, often referred to as imported residues, aretypically taken from an imported variable domain. Humanisation can beessentially performed as described by substituting human CDRs withcorresponding non-human CDRs. Accordingly, such humanised antibodies arechimeric antibodies, wherein substantially less than an intact humanvariable domain has been substituted by the corresponding sequence froma non-human species. In practice, humanised antibodies may be typicallyhuman antibodies in which some CDR residues and possibly some frameworkresidues are substituted by residues from analogous sites in non-humanantibodies.

Human antibodies can also be identified using various techniques knownin the art, including phage display libraries.

Once suitable antibodies are obtained, they may be tested for antigenspecificity, for example by ELISA.

Active Agent

The anti-uPARAP ADC of the present disclosure comprises an active agent,i.e. a drug, which can be delivered intracellularly to cells expressinguPARAP on their surface. The active agent may e.g. be a therapeuticagent, a cytotoxic agent, a radioisotope or a detectable label. In apreferred embodiment the active agent is a therapeutic agent.

In one embodiment the active agent is a chemotherapeutic agent. Classesof chemotherapeutic agents include alkylating agents, anthracyclines,antimetabolites, anti-microtubule/anti-mitotic agents, histonedeacetylase inhibitors, kinase inhibitors, peptide antibiotics,platinum-based antineoplastics, topoisomerase inhibitors and cytotoxicantibiotics.

In a preferred embodiment the active agent is a cytotoxic agent allowingfor efficient killing of the cells expressing uPARAP.

In one embodiment the active agent is an anti-mitotic agent, such asmonomethyl auristatin E (MMAE), monomethyl auristatin F (MMAF), a taxane(e.g. Paclitaxel or Docetaxel), a vinca alkaloid (e.g. Vinblastine,Vincristine, Vindesine or Vinorelbine), Colchicine or Podophyllotoxin.

In one embodiment, the cytotoxic agent is monomethyl auristatin E(MMAE). Because of its high toxicity, MMAE, which inhibits cell divisionby blocking the polymerization of tubulin, cannot be used as asingle-agent chemotherapeutic drug. However, the combination of MMAElinked to an anti-CD30 monoclonal antibody (Brentuximab Vedotin, tradename Adcetris™) has been proven to be stable in extracellular fluid,cleavable by cathepsin and safe for therapy.

In one embodiment the cytotoxic agent is monomethyl auristatin F (MMAF).MMAF is an anti-microtubule/anti-mitotic agent and a carboxyl-variant ofMMAE.

In one embodiment, the cytotoxic agent is a DNA-crosslinking agent, suchas pyrrolobenzodiazepine or a dimeric pyrrolobenzodiazepine derivative.

In one embodiment, the cytotoxic agent is a DNA alkylating agent, suchas Duocarmycin SA.

Examples of additional alkylating agents include thiotepa and CYTOXAN®cyclosphosphamide; alkyl sulfonates such as busulfan, improsulfan andpiposulfan; aziridines such as benzodopa, carboquone, meturedopa, anduredopa; ethylenimines and methylamelamines including altretamine,triethylenemelamine, trietylenephosphoramide,triethiylenethiophosphoramide and trimethylolomelamine; acetogenins(especially bullatacin and bullatacinone); delta-9-tetrahydrocannabinol(dronabinol, MARINOL®); beta-lapachone; lapachol; colchicines; betulinicacid; a camptothecin (including the synthetic analog topotecan(HYCAMTIN®), CPT-II (irinotecan, CAMPTOSAR®), acetylcamptothecin,scopolectin, and 9-aminocamptothecin); bryostatin; callystatin; CC-1065(including its adozelesin, carzelesin and bizelesin synthetic analogs);podophyllotoxin; podophyllinic acid; teniposide; cryptophycins(particularly cryptophycin 1 and cryptophycin 8); dolastatin;duocarmycin (including the synthetic analogs, KW-2189 and CBI-TMI);eleutherobin; pancratistatin; a sarcodictyin; spongistatin; nitrogenmustards such as chlorambucil, chlornaphazine, cholophosphamide,estramustine, ifosfamide, mechlorethamine, mechlorethamine oxidehydrochloride, melphalan, novembichin, phenesterine, prednimustine,trofosfamide, uracil mustard; nitrosureas such as carmustine,chlorozotocin, fotemustine, lomustine, nimustine, and ranimnustine;antibiotics such as the enediyne antibiotics (e. g., calicheamicin,especially calicheamicin gamma II and calicheamicin omega II; dynemicin,including dynemicin A; an esperamicin; as well as neocarzinostatinchromophore and related chromoprotein enediyne antiobioticchromophores), aclacinomycins, actinomycin, authramycin, azaserine,bleomycins, cactinomycin, carabicin, carminomycin, carzinophilin,chromomycinis, dactinomycin, daunorubicin, detorubicin,6-diazo-5-oxo-L-norleucine, doxorubicin (including ADRIAMYCIN®,morpholino-doxorubicin, cyanomorpholino-doxorubicin,2-pyrrolino-doxorubicin, doxorubicin HCl liposome injection (DOXIL®) anddeoxy doxorubicin), epirubicin, esorubicin, idarubicin, marcellomycin,mitomycins such as mitomycin C, mycophenolic acid, nogalamycin,olivomycins, peplomycin, potfiromycin, puromycin, quelamycin,rodorubicin, streptonigrin, streptozocin, tubercidin, ubenimex,zinostatin, zorubicin; anti-metabolites such as methotrexate,gemcitabine (GEMZAR®), tegafur (UFTORAL®), capecitabine (XELODA®), anepothilone, and 5-fluorouracil (5-FU); folic acid analogs such asdenopterin, methotrexate, pteropterin, trimetrexate; purine analogs suchas fludarabine, 6-mercaptopurine, thiamiprine, thioguanine; pyrimidineanalogs such as ancitabine, azacitidine, 6-azauridine, carmofur,cytarabine, dideoxyuridine, doxifluridine, enocitabine, floxuridine;androgens such as calusterone, dromostanolone propionate, epitiostanol,mepitiostane, testolactone; anti-adrenals such as aminoglutethimide,mitotane, trilostane; folic acid replenisher such as frolinic acid;aceglatone; aldophosphamide glycoside; aminolevulinic acid; eniluracil;amsacrine; bestrabucil; bisantrene; edatraxate; defofamine; demecolcine;diaziquone; elfornithine; elliptinium acetate; etoglucid; galliumnitrate; hydroxyurea; lentinan; lonidainine; maytansinoids such asmaytansine and ansamitocins; mitoguazone; mitoxantrone; mopidanmol;nitraerine; pentostatin; phenamet; pirarubicin; losoxantrone;2-ethylhydrazide; procarbazine; PSK® polysaccharide complex; razoxane;rhizoxin; sizofiran; spirogermanium; tenuazonic acid; triaziquone;2,2′,2″-trichlorotriethylamine; trichothecenes (especially T-2 toxin,verracurin A, roridin A and anguidine); urethan; vindesine (ELDISINE®,FILDESIN®); dacarbazine; mannomustine; mitobronitol; mitolactol;pipobroman; gacytosine; arabinoside (“Ara-C”); thiotepa; taxoids, e.g.,paclitaxel (TAXOL®), albumin-engineered nanoparticle formulation ofpaclitaxel (ABRAXANE™), and doxetaxel (TAXOTERE®); chloranbucil;6-thioguanine; mercaptopurine; methotrexate; a platinum analog such ascisplatin and carboplatin; vinblastine (VELBAN®); platinum; etoposide(VP-16); ifosfamide; mitoxantrone; vincristine (ONCOVIN®); oxaliplatin;leucovovin; vinorelbine (NAVELBINE®); novantrone; edatrexate;daunomycin; aminopterin; ibandronate; topoisomerase inhibitor RFS 2000;difluoromethylornithine (DMFO); a retinoid such as retinoic acid;pharmaceutically acceptable salts, acids or derivatives of any of theabove; as well as combinations of two or more of the above such as CHOP,an abbreviation for a combined therapy of cyclophosphamide, doxorubicin,vincristine, and prednisolone, and FOLFOX, an abbreviation for atreatment regimen with oxaliplatin (ELOXATIN®) combined with 5-FU andleucovovin.

Anti-hormonal agents act to regulate, reduce, block, or inhibit theeffects of hormones that can promote the growth of cancer, and are oftenadministered as systemic, or whole-body treatment. They may be hormonesthemselves. Examples include anti-estrogens and selective estrogenreceptor modulators (SERMs), including, for example, tamoxifen(including NOLVADEX® tamoxifen), raloxifene (EVISTA®), droloxifene,4-hydroxytamoxifen, trioxifene, keoxifene, LYI 17018, onapristone, andtoremifene (FARESTON®); anti-progesterones; estrogen receptordown-regulators (ERDs); agents that function to suppress or shut downthe ovaries, for example, luteinizing hormone-releasing hormone (LHRH)agonists such as leuprolide acetate (LUPRON® and ELIGARD®), goserelinacetate, buserelin acetate and tripterelin; other anti-androgens such asflutamide, nilutamide and bicalutamide; and aromatase inhibitors suchas, for example, 4(5)-imidazoles, aminoglutethimide, megestrol acetate(MEGASE®), exemestane (AROMASIN®), formestanie, fadrozole, vorozole(RIVISOR®), letrozole (FEMARA®), and anastrozole (ARIMIDEX®). Inaddition, bisphosphonates such as clodronate (for example, BONEFOS® orOSTAC®), etidronate (DIDROCAL®), NE-58095, zoledronic acid/zoledronate(ZOMETA®), alendronate (FOSAMAX®), pamidronate (AREDIA®), tiludronate(SKELID®), or risedronate (ACTONEL®); as well as troxacitabine (a1,3-dioxolane nucleoside cytosine analog); siRNA, ribozyme and antisenseoligonucleotides, particularly those that inhibit expression of genes insignaling pathways implicated in aberrant cell proliferation; vaccinessuch as THERATOPE® vaccine and gene therapy vaccines, for example,ALLOVECTIN® vaccine, LEUVECTIN® vaccine, and VAXID® vaccine;topoisomerase 1 inhibitor (e.g., LURTOTECAN®); rmRH (e.g., ABARELIX®);lapatinib ditosylate (an ErbB-2 and EGFR dual tyrosine kinasesmall-molecule inhibitor also known as GW572016); COX-2 inhibitors suchas celecoxib (CELEBREX®;4-(5-(4-methylphenyl)-3-(trifluoromethyl)-IH-pyrazol-1-yl)benzenesulfonamide; and pharmaceutically acceptable salts, acids orderivatives of any of the above.

In one embodiment, the active agent is a nucleotide, such as anoligonucleotide, for example an siRNA or a miRNA.

There may be one or more units of drug per antibody molecule. The ratiobetween the number of drug molecules per antibody is denoted thedrug-to-antibody ratio (DAR). In one embodiment, the DAR is between 1and 10, i.e. there will be between 1 and 10 drug units per antibodymolecule. In one embodiment, the DAR is between 2 and 8, for examplebetween 3 and 6, such as 4 or 5.

Linker

A stable link between the antibody and the active agent is an importantaspect of ADC technology. Linkers may e.g. be based on chemical motifsincluding disulfides, hydrazones or peptides (cleavable), or thioethers(noncleavable), and control the distribution and delivery of thecytotoxic agent to the target cell. Cleavable and noncleavable types oflinkers have been proven to be safe in preclinical and clinical trials.For example, Brentuximab Vedotin includes an enzyme-sensitive cleavablelinker that delivers the potent and highly toxic antimicrotubule agentmonomethyl auristatin E (MMAE), a synthetic antineoplastic agent, tocells.

Trastuzumab Emtansine, another approved ADC, is a combination of themicrotubule-formation inhibitor mertansine (DM-1), a derivative of theMaytansine, and antibody Trastuzumab (Herceptin™, Genentech/Roche),attached by a stable, non-cleavable linker.

The type of linker, cleavable or non-cleavable, lends specificproperties to the delivered drug. For example, cleavable linkers cane.g. be cleaved by enzymes in the target cell, leading to efficientintracellular release of the active agent, for example a cytotoxicagent. In contrast, an ADC containing a non-cleavable linker has nomechanism for drug release, and must rely on mechanisms such asdegradation of the targeting antibody, for drug release. Furthermore, asis appreciated by those skilled in the art, the linker composition mayinfluence critical factors such as solubility and pharmacokineticproperties of the ADC as a whole.

For both types of linker, drug release is crucial for obtaining acellular effect. Drugs which are able to freely diffuse across cellmembranes may escape from the targeted cell and, in a process called“bystander killing,” also attack neighbouring cells, such as cancercells in the vicinity of the uPARAP expressing target cell.

In a preferred embodiment the ADC targeting uPARAP as disclosed hereincomprises a linker that links the anti-uPARAP antibody and the activeagent. The linker may be cleavable or non-cleavable. In one embodimentthe linker is a cleavable linker allowing for intracellular release ofthe active agent inside the uPARAP expressing cells.

Cleavable groups include a disulfide bond, an amide bond, a substitutedamide bond in the form of a peptide bond, a thioamide, bond, an esterbond, a thioester bond, a vicinal diol bond, or a hemiacetal. These, orother cleavable bonds, may include enzymatically-cleavable bonds, suchas peptide bonds (cleaved by peptidases), phosphate bonds (cleaved byphosphatases), nucleic acid bonds (cleaved by endonucleases), and sugarbonds (cleaved by glycosidases).

The linker may e.g. be a polypeptide linker, a peptide linker or nucleicacid linker.

In particular embodiments the linker is a peptide linker. The choice ofpeptide sequence is critical to the success of the conjugate. In someembodiments the linker is stable to serum proteases, yet is cleaved bylysosomal enzymes in the target cell. In a non-limiting example thelinker is a peptide selected from protamine, a fragment of protamine,(Arg)9, biotin-avidin, biotin-streptavidin and antennapedia peptide.Other non-nucleotide linkers include alkyl or aryl chains of about 5 toabout 100 atoms. In some embodiments the linker is a nucleotide linker.

In one embodiment the linker is an enzyme-cleavable peptide-containinglinker, such as a cathepsin cleavable peptide-containing linker.Cathepsin can be one of several cathepsin types, being one of a group oflysosomal proteases.

In one embodiment the linker comprises or consists of a dipeptide, suchas valine-citrulline (VC) or valine-alanine (VA), which may be furtherconnected through an amide linkage to other structural elements.Valine-citrulline-based linkers, in which the citrulline carboxylfunction is modified to a substituted amide, can be cleaved by lysosomalcathepsins, whereas valine-alanine-based linkers, in which the alaninecarboxyl function is modified to a substituted amide, can be cleaved byother lysosomal proteases, including other cathepsins.

In one embodiment the ADC of the present disclosure further comprises aspacer. The spacer may for example connect the linker and the activeagent. In one embodiment, the spacer is paraaminobenzoic acid (PAB).

In one embodiment the spacer is or includes a polyethylenglycol spacer,such as a PEG4 spacer.

In one embodiment the ADC of the present disclosure further comprises anattachment entity. The attachment entity may for example connect theantibody and the cleavable linker, where the attachment entity is thereaction product between an antibody amino acid side chain and areactive attachment group in the linker precursor. In one embodiment,this reactive attachment group comprises or consists of maleimide andcaproic acid (MC), where maleimide reacts preferably with cysteinethiols during coupling. In other embodiments, the attachment groupcomprises or consists of N-hydroxysuccinimide, azides or alkynes.

In one embodiment the ADC of the present disclosure comprises ananti-uPARAP antibody as disclosed herein and the linker-drug complexVedotin. Vedotin is a linker-drug complex comprising the cytotoxic agentMMAE, a spacer (paraaminobenzoic acid), a cathepsin-cleavable linker(Valine-citrulline dipeptide) and an attachment group consisting ofcaproic acid and maleimide. Vedotin is MC—VC-PAB-MMAE. BrentuximabVedotin (trade name Adcetris™) is an example of an FDA-approved ADCcomprising Vedotin.

In one embodiment, the ADC of the present disclosure comprises ananti-uPARAP antibody as disclosed herein and a linker-spacer-toxin unitbeing VC-PAB-MMAF.

In one embodiment, the ADC of the present disclosure comprises ananti-uPARAP antibody as disclosed herein and a linker-spacer-toxin unitbeing PEG4-VA-PBD.

In one embodiment, the ADC of the present disclosure comprises ananti-uPARAP antibody as disclosed herein and a linker-spacer-toxin unitbeing PEG4-VC-DuocarmycinSA.

In one embodiment, the ADC of the present disclosure comprises alinker-drug complex as described in US 2006/074008, which isincorporated by reference in its entirety.

The linker-drug construct may e.g. be attached to the anti-uPARAPantibody by maleimide chemistry to thiols of reduced interchain orintrachain disulphide bridges.

Therapeutic Use

The ADCs directed against uPARAP as described herein are useful for thedelivery of active agents, such as therapeutic or cytotoxic agents tocells expressing uPARAP and thus for the treatment of a range ofdiseases and disorders characterized by uPARAP expression, in particularuPARAP overexpression.

In one embodiment, the present disclosure provides a pharmaceuticalcomposition comprising an effective amount of a anti-uPARAP ADC, asdescribed herein, together with a pharmaceutically acceptable buffer,diluent, carrier, adjuvant or excipient.

The pharmaceutical compositions may be prepared in a manner known in theart that is sufficiently storage stable and suitable for administrationto humans and/or animals. For example, the pharmaceutical compositionsmay be lyophilised, e.g. through freeze drying, spray drying, spraycooling, or through use of particle formation from supercriticalparticle formation.

By “pharmaceutically acceptable” we mean a non-toxic material that doesnot decrease the effectiveness of the anti-uPARAP ADC. Suchpharmaceutically acceptable buffers, carriers or excipients arewell-known in the art (see Remington's Pharmaceutical Sciences, 18thedition, A. R Gennaro, Ed., Mack Publishing Company (1990) and handbookof Pharmaceutical Excipients, 3rd edition, A. Kibbe, Ed., Pharmaceutical

Press (2000), the disclosures of which are incorporated herein byreference).

The term “buffer” is intended to mean an aqueous solution containing anacid-base mixture with the purpose of stabilising pH. Pharmaceuticallyacceptable buffers are well known in the art.

The term “diluent” is intended to mean an aqueous or non-aqueoussolution with the purpose of diluting the agent in the pharmaceuticalpreparation.

The term “adjuvant” is intended to mean any compound added to theformulation to increase the biological effect of the agent of theinvention. The adjuvant may be one or more of zinc, copper or silversalts with different anions, for example, but not limited to fluoride,chloride, bromide, iodide, thiocyanate, sulfite, hydroxide, phosphate,carbonate, lactate, glycolate, citrate, borate, tartrate, and acetatesof different acyl composition. The adjuvant may also be cationicpolymers such as cationic cellulose ethers, cationic cellulose esters,deacetylated hyaluronic acid, chitosan, cationic dendrimers, cationicsynthetic polymers such as poly(vinyl imidazole), and cationicpolypeptides such as polyhistidine, polylysine, polyarginine, andpeptides containing these amino acids.

The excipient may be one or more of carbohydrates, polymers, lipids andminerals. Examples of carbohydrates include lactose, glucose, sucrose,mannitol, and cyclodextrines, which are added to the composition, e.g.,for facilitating lyophilisation. Examples of polymers are starch,cellulose ethers, cellulose carboxymethylcellulose, hydroxypropylmethylcellulose, hydroxyethyl cellulose, ethylhydroxyethyl cellulose,alginates, carageenans, hyaluronic acid and derivatives thereof,polyacrylic acid, polysulphonate, polyethylenglycol/polyethylene oxide,polyethyleneoxide/polypropylene oxide copolymers,polyvinylalcohol/polyvinylacetate of different degree of hydrolysis, andpolyvinylpyrrolidone, all of different molecular weight, which are addedto the composition, e.g., for viscosity control, for achievingbioadhesion, or for protecting the lipid from chemical and proteolyticdegradation. Examples of lipids are fatty acids, phospholipids, mono-,di-, and triglycerides, ceramides, sphingolipids and glycolipids, all ofdifferent acyl chain length and saturation, egg lecithin, soy lecithin,hydrogenated egg and soy lecithin, which are added to the compositionfor reasons similar to those for polymers. Examples of minerals aretalc, magnesium oxide, zinc oxide and titanium oxide, which are added tothe composition to obtain benefits such as reduction of liquidaccumulation or advantageous pigment properties.

The ADCs of the present disclosure may be formulated into any type ofpharmaceutical composition known in the art to be suitable for thedelivery thereof.

The ADCs of the present disclosure or pharmaceutical compositionscomprising the ADCs may be administered via any suitable route known tothose skilled in the art. Thus, possible routes of administrationinclude parenteral (intravenous, subcutaneous, and intramuscular),topical, ocular, nasal, pulmonar, buccal, oral, vaginal and rectal.Also, administration from implants is possible.

In one preferred embodiment, the pharmaceutical compositions areadministered parenterally, for example, intravenously,intracerebroventricularly, intraarticularly, intra-arterially,intraperitoneally, intrathecally, intraventricularly, intrasternally,intracranially, intramuscularly or subcutaneously, or they may beadministered by infusion techniques. They are conveniently used in theform of a sterile aqueous solution which may contain other substances,for example, enough salts or glucose to make the solution isotonic withblood. The aqueous solutions should be suitably buffered if necessary.The preparation of suitable parenteral formulations under sterileconditions is readily accomplished by standard pharmaceutical techniqueswell known to those skilled in the art.

Formulations suitable for parenteral administration include aqueous andnon-aqueous sterile injection solutions which may contain anti-oxidants,buffers, bacteriostats and solutes which render the formulation isotonicwith the blood of the intended recipient; and aqueous and non-aqueoussterile suspensions which may include suspending agents and thickeningagents. The formulations may be presented in unit-dose or multi-dosecontainers, for example sealed ampoules and vials, and may be stored ina freeze-dried (lyophilised) condition requiring only the addition ofthe sterile liquid carrier, for example water for injections,immediately prior to use. Extemporaneous injection solutions andsuspensions may be prepared from sterile powders, granules and tabletsof the kind previously described.

In one embodiment the ADCs of the present disclosure are administeredintravenously.

In one embodiment the ADCs of the present disclosure are administeredsubcutaneously.

In one embodiment the ADCs of the present disclosure are administeredintracranially or intracerebrally.

The pharmaceutical compositions will be administered to a patient in apharmaceutically effective amount. A ‘therapeutically effective amount’,or ‘effective amount’, or ‘therapeutically effective’, as used herein,refers to that amount which provides a therapeutic effect for a givencondition and administration regimen. This is a predetermined quantityof active material calculated to produce a desired therapeutic effect inassociation with the required additive and diluent, i.e. a carrier oradministration vehicle. Further, it is intended to mean an amountsufficient to reduce, and most preferably prevent, a clinicallysignificant deficit in the activity, function and response of the host.Alternatively, a therapeutically effective amount is sufficient to causean improvement in a clinically significant condition in a host. As isappreciated by those skilled in the art, the amount of a compound mayvary depending on its specific activity. Suitable dosage amounts maycontain a predetermined quantity of active composition calculated toproduce the desired therapeutic effect in association with the requireddiluent. A therapeutically effective amount can be determined by theordinarily skilled medical or veterinary worker based on patientcharacteristics, such as age, weight, sex, condition, complications,other diseases, etc., as is well known in the art. The administration ofthe pharmaceutically effective dose can be carried out both by singleadministration in the form of an individual dose unit, or else severalsmaller dose units, and also by multiple administrations of subdivideddoses at specific intervals. Alternatively, the dose may be provided asa continuous infusion over a prolonged period.

It will be appreciated by persons skilled in the art that the ADCstargeting uPARAP described herein may be administered alone or incombination with other therapeutic agents. For example, the ADCstargeting uPARAP described herein may be administered in combinationwith a range of anti-cancer agents, such as antimetabolites, alkylatingagents, anthracyclines and other cytotoxic antibiotics, vinca alkyloids,anti-microtubule/anti-mitotic agents, histone deacetylase inhibitors,kinase inhibitors, peptide antibiotics, platinum-based antineoplastics,etoposide, taxanes, topoisomerase inhibitors, antiproliferativeimmunosuppressants, corticosteroids, sex hormones and hormoneantagonists, cytotoxic antibiotics and other therapeutic agents.

In one embodiment the ADC of the present disclosure is administered inconjunction with additional reagents and/or therapeutics that mayincrease the functional efficiency of the ADC, such as established ornovel drugs that increase lysosomal membrane permeability, therebyfacilitating molecular entry from the lysosome interior to thecytoplasm, or drugs that increase the permeability of the blood-brainbarrier.

In one embodiment the present disclosure provides a kit comprising anADC targeting uPARAP as described herein or a pharmaceutical compositioncomprising same. The kit may optionally further comprise means foradministering the ADC to a subject and instructions for use.

In one embodiment the present disclosure relates to a method fordelivery of an active agent to a uPARAP-expressing cell in a subjectcomprising administering to the subject a uPARAP-directed ADC or acomposition comprising a uPARAP-directed ADC as described herein, suchthat the active agent is delivered to said cell.

In one embodiment the present disclosure relates to the uPARAP-directedADC or a composition comprising said uPARAP-directed ADC as describedherein, for use in the delivery of an active agent to auPARAP-expressing cell in a subject, comprising administering to thesubject a uPARAP-directed ADC or a composition comprising auPARAP-directed ADC as described herein, such that the active agent isdelivered to said cell.

In one embodiment the present disclosure relates to a method fortreatment of a disease or disorder characterised by cells expressinguPARAP in a subject, comprising administering to the subject auPARAP-directed ADC or a composition comprising a uPARAP-directed ADC asdescribed herein to said subject.

In one embodiment the present disclosure relates to the uPARAP-directedADC or a composition comprising said uPARAP-directed ADC as describedherein for use in the treatment of a disease or disorder characterisedby cells expressing uPARAP.

In one embodiment the present disclosure relates to a method forinhibiting the growth of a cell expressing uPARAP in vivo or in vitrocomprising administering a uPARAP-directed ADC or a compositioncomprising a uPARAP-directed ADC as described herein. This inhibition ofgrowth may include cell death or may include growth inhibition withoutcell death.

In a particularly preferred embodiment the uPARAP-expressing cell is atumour cell and/or a tumour associated cell and the present disclosurerelates to a method for treatment of cancer in a subject, comprisingadministering to the subject the uPARAP-directed ADC or a compositioncomprising a uPARAP-directed ADC as described herein to said subject.

Tumour associated cells include, but are not limited to, activatedfibroblasts, myofibroblasts, neovasculature and infiltrating cells ofthe macrophage-monocyte lineage or other leukocytic cell types, as wellas cells of the stromal tissue surrounding the tumour.

In one embodiment the present disclosure relates to a method forinhibiting tumour progression in a subject, comprising administering tothe subject a uPARAP-directed ADC or a composition comprising auPARAP-directed ADC as described herein to said subject. This inhibitionof tumor progression may include complete or incomplete eradication oftumors, or may include growth arrest without cell death.

In one embodiment the present disclosure relates to a method forinhibiting, lowering or eliminating metastatic capacity of a tumour in asubject, comprising administering to the subject a uPARAP-directed ADCor a composition comprising a uPARAP-directed ADC as described herein tosaid subject.

In one embodiment the tumour cells express or overexpress uPARAP.

In one embodiment the tumour associated cells express or overexpressuPARAP.

In one embodiment the present disclosure provides a method for inducingcell death and/or inhibiting the growth and/or proliferation of cellsexpressing uPARAP, comprising the step of administering to theindividual an effective amount of an ADC targeting uPARAP as describedherein, or a pharmaceutical composition comprising an ADC targetinguPARAP as described herein.

The treatment preferably induces cell death and/or inhibits the growthand/or proliferation of the uPARAP expressing cells, such as tumourcells or tumour associated cells.

In one embodiment the treatment is ameliorative.

In one embodiment the treatment is curative.

In one embodiment the present disclosure provides an ADC targetinguPARAP as described herein for the preparation of a medicament forinducing cell death and/or inhibiting the growth and/or proliferation ofcells expressing uPARAP, such as tumour cells or tumour associatedcells.

The expression and role of uPARAP in cancer has been investigated byseveral research groups; cf. review by Melander et al (Melander et al.,2015, Int J Oncol 47: 1177-1188) and article by Engelholm et al(Engelholm et al., 2016, J. Pathol. 238, 120-133).

In one embodiment the cancer is a solid tumour, wherein the tumour cellsand/or the tumour associated cells express uPARAP.

In one embodiment the cancer is a solid tumour, wherein the tumour cellsexpress uPARAP.

Examples of cancers characterized by overexpression of uPARAP include,but are not limited to, sarcoma, including osteosarcoma (Engelholm etal., 2016, J Pathol 238(1): 120-33) as well as other sarcomas,glioblastoma (Huijbers et al., 2010, PLoS One 5(3):e9808), prostatecancer and bone metastases from prostate cancer (Kogianni et al., 2009,Eur J Cancer 45(4): 685-93), breast cancer and in particular “basallike” breast cancer (Wienke et al., 2007, Cancer Res 1; 67(21):10230-40), and head- and neck cancer (Sulek et al., 2007, J HistochemCytochem 55(4): 347-53).

In one embodiment the cancer is sarcoma, such as osteosarcoma,liposarcoma, myxofibrosarcoma, dermatofibrosarcoma protuberans (DFSP)and/or leiomyosarcoma (LMS).

In one embodiment the cancer is glioblastoma.

In one embodiment the cancer is a solid tumour, wherein the tumourassociated cells express uPARAP. When uPARAP is expressed by tumourassociated cells, the therapeutic effect is believed to be mediated viathe so-called “by-stander” effect and/or via reduction and/orelimination of stromal cell-mediated stimulation of tumour growth anddissemination.

Examples of cancers characterized by overexpression of uPARAP in thetumour associated cells include but are not limited to breast cancer(Schnack et al., 2002, Int J Cancer 10; 98(5): 656-64), head- and neckcancer (Sulek et al., 2007, J Histochem Cytochem 55(4): 347-53) andmultiple other solid malignant tumours.

In one embodiment, the cancer is not a solid tumour. For instance, theADC of the present disclosure may e.g. be used for the treatment ofuPARAP-expressing leukemia, for example, from the macrophage-monocytelineage.

In other embodiments, the disease or disorder characterised by cellsexpressing uPARAP is not cancer.

uPARAP is involved in bone growth and homeostasis (Madsen et al., 2013,PLoS One 5; 8(8): e71261). Thus, in one embodiment the ADC of thepresent disclosure may be used for the treatment of a diseasecharacterized by bone degradation, wherein the bone degradation ismediated by non-malignant cells, such as osteoporosis.

Due to its role in collagen accumulation, a role for uPARAP has alsobeen shown in fibrosis (Madsen et al., 2012, J Pathol 227(1):94-105).Thus, in one embodiment the ADC of the present disclosure may be usedfor the treatment of fibrosis, for example of kidney, lung and liver.

In one embodiment the ADC of the present disclosure may be used for thetreatment of diseases and disorders associated with macrophages,including atherosclerosis and chronic inflammation.

REFERENCES

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Example 1: In Vitro and In Vivo Efficacy of ADCs Directed Against theN-Terminal Region of uPARAP

Materials and Methods

Preparation and Evaluation of mAb-Vc-MMAE ADCs

Monoclonal antibodies (mAbs) against uPARAP or against trinitrophenol(TNP) were generated and produced using hybridoma technique afterimmunization of mice, according to established methods known in the art.In the case of mAbs against uPARAP, the host mice for immunization weregene deficient with respect to uPARAP, leading to antibodies reactivewith both the human and the murine antigen. ADCs were prepared by acommonly employed conjugation method, described previously in the art(Doronina et al. 2003 Nature biotechnology 21(7):778-84; Francisco etal., 2003. Blood 102(4):1458-65; Hamblett et al., 2004. Clinical cancerresearch 10(20):7063-70).

Antibodies were subjected to mild reduction by a 10 minute incubation at37° C. in the presence of 10 mM DTT in a 50 mM sodium borate, 50 mMNaCl, pH 8.0 buffer at 5 mg/mL concentration, followed by removal of DTTby buffer exchange using 30 kDa NMWL centrifugal filters to fresh PBS pH7.4 with 1 mM EDTA, then adjusted to 2 mg/mL concentration. This wasfollowed by immediate conjugation to a 5-10 times molar surplus ofmaleimidocaproyl-valine-citrulline-p-aminobenzoyloxycarbonyl-monomethylauristatin E (MC—VC-PAB-MMAE, i.e. Vedotin), dissolved in water-freeDMSO to a final DMSO content of 10% v/v during conjugation for 2 hoursat 37° C. The resulting mAb-vc-MMAE ADCs were purified by gel filtrationon PD-10 desalting columns. The average drug-to-antibody ratio (DAR) ofthe resulting ADCs was determined based on the absorbance ratio ofpurified conjugate samples at A=248 nm and λ=280 nm. Unmodified mAbsdisplay an λ_(248 nm)/λ_(280 nm) ratio of 0.43, and the λ_(MAX) at λ=248nm of MMAE gives rise to a higher λ_(248 nm)/λ_(280 nm) ratio formAb-vc-MMAE ADCs, which has been demonstrated to reflect the DAR of theresulting ADCs (Hamblett et al., 2004. Clinical cancer research10(20):7063-70; Sanderson et al., 2005. Clinical Cancer Research11:843-852).

Cell Lines

U937, THP-1 and HT1080 cells were all obtained from ATCC. KNS42 cellswere kindly provided by Lara Perryman, Biotech Research and InnovationCentre (BRIC), University of Copenhagen. CHO-K1 cells were obtained fromInvitrogen. All cells were maintained in appropriate medium supplementedwith 10% fetal bovine serum and 1% penicillin/streptomycin, in a 37° C.,5% CO₂ atmosphere incubator.

SDS-PAGE Analysis of Conjugate Species

Reducing SDS-PAGE was performed by running a 4-12% NuPAGE Bis-TrisSDS-PAGE gel, loading 5 μg of total protein per lane, reduced by boilingfor 3 minutes in sample buffer in the presence of 40 mM DTT. The gelswere stained using a standard 0.1% coomassie blue stain. For cathepsin Blinker cleavage assay, samples were treated with recombinant human (rh)Cathepsin B according to manufacturer's instructions, using 100 ng ofactivated rhCathepsin B to 20 μg ADC (mAb component), in a 25 mM MES, pH5.0 buffer, and incubation at 37° C. overnight.

ELISA Analysis of uPARAP-Binding of mAbs

A 96-well ELISA plate was coated with 25 ng/well of a soluble truncateduPARAP protein containing the first 3 N-terminal domains of humanuPARAP, with intact epitope for mAb 2h9. Untreated mAbs (2h9 or aTNP),same mAbs subjected to the reduction procedure of conjugation (seeabove), or ADCs 2h9-vc-MMAE or aTNP-vc-MMAE, were then employed as aprimary antibody, followed by a HRP-conjugated rabbit anti-mouse Igsecondary antibody. Finally an o-phenylenediaminedihydrochloride-containing substrate solution was added, and the colorreaction was stopped by adding 1M H₂SO₄. Plates were read at 492 nmusing a plate reader.

In Vitro Cytotoxicity of ADCs—Cell Viability Assay

Cells tested were seeded at low density (20-25% confluence, generally5-10×10³ cells per well) in a 96 well plate in 90 μL of medium, andincubated overnight. The next day, mAb-vc-MMAE conjugates based on mAb2h9, mAb 5f4 or non-targeted control mAb aTNP were prepared as a serialdilution (1:4) in PBS and added in volumes of 10 μL to each well, with afinal maximum ADC concentration of 10 μg/mL mAb component. Cells wereincubated for 72 hours, before 20 μL of CellTiter 96 AQueous OneSolution Cell Proliferation Assay (MTS, Promega) was added, andincubated for an appropriate time for formation of color (usually 1hour). The plates were then read at 490 nm, with background subtractionat 630 nm, using a plate reader.

In Vitro Cytotoxicity of ADCs—Cell Cycle Analysis

Cell cycle analysis was performed using a Nucleocounter NC-3000 system(ChemoMetec Denmark), using the manufacturers standard protocol foranalyzing the cell cycle distribution of a population of cells, based onthe DNA content of each cell. The percentage of cells in Sub-G1, G1, S,or G2/M-phases of the cell cycle was established from histogram analysisusing the NucleoView NC-3000 software.

Receptor Competition and Lysosomal Protease Inhibition

For receptor competition assay, receptor depletion assay, and assay forinhibition of lysosomal proteases, U937 cells were seeded as for a cellviability assay (see above). For receptor competition assay, a constant2h9-vc-MMAE concentration of 1 μg/mL mAb component was kept in allwells, and the unmodified competition mAb was simultaneously added in adilution series (1:2) starting at a concentration of 8 μg/mL competitivemAb. Cells were then subjected to a 72 hour cytotoxicity cell viabilityassay (see above). For the assay of inhibition of lysosomal proteases,U937 cells were pre-incubated with 20 μM of E64D protease inhibitor for2 hours, before starting a 72 hour cytotoxicity cell viability assay(see above).

Animal Experiments

All animal experiments were performed under legal approval from TheDanish Veterinary and Food Administration. All reagents and cell linesused for animal experiments were tested negative for the presence ofmurine viruses, bacteria, mycoplasma and fungi. Animals receivedstandard of care, and were sacrificed upon any of the following signs:loss of more than 10% of body weight, visible distress or illness,compromised food- or water intake or defecation, signs of severeinflammation in the vicinity of tumours, or tumour growth which exceededa volume of 1000 mm³ or compromised the free movement of the animals.Tumour growth was measured using electronic calipers, and tumour volumeswere calculated using the formula Volume=(L×W²)/2, with L being thelongest dimension of the tumour, and W being the width in theperpendicular dimension.

Treatment of a Subcutaneous uPARAP-Positive 0937 Xenograft Tumour Modelin Mice by s.c. Injection

For tumour establishment, mice were shaved at the flank, and received asubcutaneous injection of 1×10⁶ U937 cells, and then closely monitoredin order to observe the development of solid tumours. Upon formation ofpalpable tumours with a volume of 50-100 mm³, the mice started treatmentin one of four treatment groups: 2h9-vc-MMAE (N=10), aTNP-vc-MMAE (N=9),unmodified mAb 2h9 (N=5) or PBS vehicle control (N=5). All treatmentswere given as a total of 4 subcutaneous doses of 3 mg/kg mAb componentin the tumour area, at 4 days intervals. Injections were performed underbrief isoflurane anesthesia to avoid risks for the animal handler.During treatment, the tumours were evaluated every two days, untilreaching a point of sacrifice. Mice which fully lost any tumour burdenwere checked two times a week for a period of 3 months after endingtreatment.

Treatment of a Subcutaneous uPARAP-Positive 0937 Xenograft Tumour Modelin Mice by Intravenous Injection

For tumour establishment, mice were shaved at the flank, and received asubcutaneous injection of 1×10⁶ U937 cells, and then closely monitoredin order to observe the development of solid tumours. Upon formation ofpalpable tumours with a volume of 50-100 mm³, the mice started treatmentin one of four treatment groups: 2h9-vc-MMAE (N=10), aTNP-vc-MMAE(N=10), unmodified mAb 2h9 (N=5) or PBS vehicle control (N=5). Alltreatments were given as a total of 3 intravenous doses of 5 mg/kg mAbcomponent in the tail veins of the mice, at 4 days intervals. Duringtreatment, the tumours were evaluated every two days, until reaching apoint of sacrifice. Mice which fully lost any tumour burden were checkedtwo times a week for a period of 3 months after ending treatment.

Statistics

All samples were done in triplicates. Error bars: Standard deviation.

Results and Conclusions

The collagen receptor uPARAP is upregulated in the tumour cells ofspecific cancers, including sarcomas and late-stage glioblastoma.Additionally, the receptor is most often upregulated in stromal cellssurrounding solid tumours. In healthy adult individuals, the receptordisplays a restricted expression, thus making it a potential target forADC therapy.

For this purpose, we selected a monoclonal antibody, 2h9, obtained afterimmunization of a uPARAP gene-deficient mouse, and prepared auPARAP-directed ADC (2h9-vc-MMAE) using a well-established conjugationmethod. The targeting antibody 2h9 was shown to tolerate the conjugationprocedure well, with negligible loss of affinity. The resulting ADC wasshown to be highly specific in killing or inducing growth arrest inuPARAP-positive cells in vitro, with U937 cells being the most sensitivecell line tested. uPARAP is a constitutively recycling receptor,directing its cargo to the lysosomal compartment. We found that ADCefficiency in highly sensitive cells such as U937 cells was completelydependent on linker cleavage, since uPARAP-dependent cytotoxicity wasabrogated after inhibition of lysosomal cathepsins with E64D. Therefore,we suggest that the lysosomal capacity for cleavage of the linkercontributes to differences in ADC sensitivity between different celltypes, in collaboration with overall differences in sensitivity towardsthe conjugated cytotoxin.

For in vivo studies, we utilized a fast-growing subcutaneous xenografttumour model with U937 cells in CB17 SCID mice. Using this model, ADC2h9-vc-MMAE was found to be highly efficient at eradicating solid U937tumours in vivo. Following treatment by local subcutaneousadministration, 5 mice remained tumour-free 90 days after finishing thetreatment regimen, hence constituting a 50% cure rate. More importantly,following treatment by intravenous administration, we observed a potenteffect resulting in a 100% cure rate. Notably, this eradication oftumours was obtained without any evident adverse effects upon regularinspection of the treated mice. Importantly, the 2h9 antibody isreactive against both human and murine uPARAP, a cross-reactivityenabled by the use of a uPARAP-deficient mouse for immunization whenraising the antibody. Therefore, in this xenograft model, in addition tobeneficial anti-tumoural effects, any potential detrimental side effectson the host would be revealed, but no signs of detrimental effects wereseen.

The epitope for the 2h9 antibody is located within the first threeN-terminal domains of uPARAP, more particularly in either the CysRdomain or CTLD-1. In vitro studies presented herein indicate thatanother ADC comprising an anti-UPARAP antibody targeting the first threeN-terminal domains of uPARAP, namely 5f4, is as efficient as ADCscomprising the 2h9 antibody. The epitope for the 5f4 antibody is in theFN-II domain of uPARAP. Thus, we hypothesize that ADCs comprisinganti-uPARAP antibodies directed against epitopes within the first threeN-terminal domains of uPARAP are particularly efficient as ADCs.

In conclusion, the data presented here very strongly support the notionof the collagen receptor uPARAP as a versatile target in ADC cancertherapy based on expression pattern and molecular function. Furthermore,these data show that ADCs comprising antibodies directed against thefirst three N-terminal domains of uPARAP, such as ADC 2h9-vc-MMAE, arehighly efficient for targeting of uPARAP-expressing cells in vitro andin vivo.

Example 2: In Vitro Efficacy of MMAE-Based ADCs

In addition to the ADCs of Example 1, the following MMAE ADCs weregenerated: 967-vc-MMAE and 11c9-vc-MMAE.

mAb 2h9, mAb 5f4 and mAb 967 are directed against epitopes within thethree N-terminal domains of uPARAP, while mAb 11c9 is an anti-uPARAPantibody directed against an epitope outside the N-terminal threedomains of uPARAP.

In vitro cell viability assays with U937 cells were performed asdescribed in Example 1, using all of these ADCs. All ADCs lead to aspecific reduction in overall cell viability but with the cellularsensitivity to 2h9-vc-MMAE, 5f4-vc-MMAE and 967-vc-MMAE beingsignificantly higher than the sensitivity to 11c9-vc-MMAE (FIG. 14).

Thus, the inventors conclude that ADCs comprising anti-uPARAP antibodiescapable of binding to epitopes within the three most N-terminal domainsof uPARAP are very efficient ADCs.

Example 3: In Vitro Efficacy of ADCs Comprising Different Linkers,Spacers and Toxins

Different toxins can be used in an ADC format targeting the N-terminalpart of uPARAP. ADCs with mAb 2h9 as the antibody component wereprepared as described above but using the following linker-cytotoxinunits instead of VC-PAB-MMAE:

-   -   VC-PAB-MMAF (with MMAF being monomethyl auristatin F, a        carboxyl-variant of MMAE)    -   PEG4-va-PBD (with PEG4 referring to a polyethylenglycol spacer,        va being valine-alanine and PBD referring to a dimeric        pyrrolobenzodiazepine)    -   PEG4-vc-Duocarmycin SA (with PEG4 referring to a        polyethylenglycol spacer and vc being valine-citrulline)

The resulting ADCs (referred to as 2h9-vc-MMAF, 2h9-va-PBD and2h9-vc-DuocSA, respectively) were used for in vitro cell viabilityassays with U937 cells, performed as described above. U937 cellsdisplayed very strong sensitivity to 2h9-vc-MMAF, a more moderatesensitivity to 2h9-va-PBD and a low but measurable sensitivity to2h9-vc-DuocSA. The results are shown in FIGS. 15 and 16.

Example 4: In Vitro Efficacy of ADCs on Human Glioblastoma Explant Cells

The ADCs 2h9-vc-MMAE and 2h9-vc-MMAF were tested by in vitro cellviability assays, performed as described in Example 1, for theircapacity to specifically kill human glioblastoma explant cells.Glioblastoma explant cells are e.g. described in Staberg et al., 2017,Cell Oncol. 40: 21-32. These cells displayed a very strong and specificsensitivity towards both ADC 2h9-vc-MMAE, as well as ADC 2h9-vc-MMAF,thus demonstrating high efficacy of these ADCs in combating humanglioblastoma cells. The results are shown in FIG. 17.

Example 5: Recombinant Antibody

The protein product encoded by a synthetic DNA, comprising [SEQ ID NO:1] (light chain of monoclonal antibody 2h9 against uPARAP) and [SEQ IDNO: 5] (heavy chain of the same antibody), was expressed in CHO cells.The resulting recombinant antibody product was purified and was shown byWestern blotting to specifically recognize uPARAP in the same manner asmonoclonal antibody 2h9 produced by hybridoma cell culture (FIG. 18).

1. An antibody-drug conjugate directed against uPARAP comprising: a. anantibody capable of binding to: i. the amino acid sequence of SEQ ID NO:36 or 37 (CysR-FN-II-CTLD-1 domains of uPARAP), ii. the amino acidsequence of SEQ ID NO: 38 or 39 (CysR-FN-II domains of uPARAP), iii. theamino acid sequence of SEQ ID NO: 40 or 41 (FN—II-CTLD-1 domains ofuPARAP), iv. the amino acid sequence of SEQ ID NO: 30 or 31 (thecystein-rich domain (CysR) of uPARAP) v. the amino acid sequence of SEQID NO: 32 or 33 (the Fibronectin type II (FN-II) domain of uPARAP),and/or vi. the amino acid sequence of SEQ ID NO: 34 or 35 (the C-typelectin-like domain 1 (CTLD 1) of uPARAP), b. an active agent, andoptionally c. a linker which links a) to b).
 2. The antibody-drugconjugate according to claim 1, wherein the antibody is capable ofbinding to a. the amino acid sequence of SEQ ID NO: 30 or 31, or b. theamino acid sequence of SEQ ID NO: 34 or
 35. 3. The antibody-drugconjugate according to claim 1, wherein the antibody is capable ofbinding to the amino acid sequence of SEQ ID NO: 32 or
 33. 4. Theantibody-drug conjugate according to any of the preceding claims,wherein the antibody is selected from the group consisting of: a. anantibody or antigen-binding fragment thereof comprising i. animmunoglobulin light chain variable region comprising or consisting ofthe amino acid sequence of SEQ ID NO: 1 or 9 or a sequence having atleast 70% sequence identity thereto, and/or ii. an immunoglobulin heavychain variable region comprising or consisting of the amino acidsequence of SEQ ID NO: 5 or 10 or a sequence having at least 70%sequence identity thereto, b. an antibody or antigen-binding fragmentthereof that binds to the same epitope as the antibody of a), c. ahumanised version of the antibody or antigen-binding fragment thereof ofa), or a humanised version of the antibody or antigen-binding fragmentthereof of b), d. a chimeric version of the antibody or antigen-bindingfragment thereof of a), or a chimeric version of the antibody orantigen-binding fragment thereof of b), e. an antibody orantigen-binding fragment thereof comprising i. one or more of the aminoacid sequences of SEQ ID NOs: 2, 3, 4, 6, 7 and 8, or ii. the amino acidsequences of SEQ ID NOs: 2, 3 and 4, and/or the amino acid sequences ofSEQ ID NOs 6, 7 and
 8. f. an antibody or antigen-binding fragmentthereof comprising i. one or more of the amino acid sequences of SEQ IDNOs: 42, 43, 44, 45, 46 and 47, or ii. the amino acid sequences of SEQID NOs: 42, 43 and 44, and/or the amino acid sequences of SEQ ID NOs 45,46 and
 47. 5. The antibody-drug conjugate according to any of thepreceding claims, wherein the antibody is selected from the groupconsisting of: a. an antibody or antigen-binding fragment thereofcomprising i. an immunoglobulin light chain variable region comprisingor consisting of the amino acid sequence of SEQ ID NO: 11 or a sequencehaving at least 70% sequence identity thereto, and/or ii. animmunoglobulin heavy chain variable region comprising or consisting ofthe amino acid sequence of SEQ ID NO: 15 or a sequence having at least70% sequence identity thereto, b. an antibody or antigen-bindingfragment thereof that binds to the same epitope as the antibody of a),c. a humanised version of the antibody or antigen-binding fragmentthereof of a), or a humanised version of the antibody or antigen-bindingfragment thereof of b), d. a chimeric version of the antibody orantigen-binding fragment thereof of a), or a chimeric version of theantibody or antigen-binding fragment thereof of b), e. an antibody orantigen-binding fragment thereof comprising i. one or more of the aminoacid sequences of SEQ ID NOs: 12, 13, 14, 16, 17 and 18, or ii. theamino acid sequences of SEQ ID NOs: 12, 13 and 14, and/or the amino acidsequences of SEQ ID NOs 16, 17 and
 18. f. an antibody or antigen-bindingfragment thereof comprising i. one or more of the amino acid sequencesof SEQ ID NOs: 48, 49, 50, 51, 52 and 53, or ii. the amino acidsequences of SEQ ID NOs: 48, 49 and 50, and/or the amino acid sequencesof SEQ ID NOs 51, 52 and
 53. 6. The antibody-drug conjugate according toany of the preceding claims, wherein the antibody is selected from thegroup consisting of: a. an antibody or antigen-binding fragment thereofcomprising i. an immunoglobulin light chain variable region comprisingor consisting of the amino acid sequence of SEQ ID NO: 19 or 20 or asequence having at least 70% sequence identity thereto, and/or ii. animmunoglobulin heavy chain variable region comprising or consisting ofthe amino acid sequence of SEQ ID NO: 24 or 25 or a sequence having atleast 70% sequence identity thereto, b. an antibody or antigen-bindingfragment thereof that binds to the same epitope as the antibody of a),c. a humanised version of the antibody or antigen-binding fragmentthereof of a), or a humanised version of the antibody or antigen-bindingfragment thereof of b), d. a chimeric version of the antibody orantigen-binding fragment thereof of a), or a chimeric version of theantibody or antigen-binding fragment thereof of b), e. an antibody orantigen-binding fragment thereof comprising i. one or more of the aminoacid sequences of SEQ ID NOs: 21, 22, 23, 26, 27 and 28, or ii. theamino acid sequences of SEQ ID NOs: 21, 22 and 23, and/or the amino acidsequences of SEQ ID NOs 26, 27 and
 28. f. an antibody or antigen-bindingfragment thereof comprising i. one or more of the amino acid sequencesof SEQ ID NOs: 54, 55, 56, 57, 58 and 59, or ii. the amino acidsequences of SEQ ID NOs: 54, 55 and 56, and/or the amino acid sequencesof SEQ ID NOs 57, 58 and
 59. 7. The antibody-drug conjugate according toany of the preceding claims, wherein any sequence variance is outsidethe complementarity determining regions.
 8. The antibody-drug conjugateaccording to any of the preceding claims, wherein the antibody isselected from a mouse antibody, a chimeric antibody, a human antibody, ahumanised antibody, a humanised antigen-binding fragment, a Fabfragment, a Fab′ fragment, an F(ab′)2 fragment, an Fv, a single chainantibody (SCA) such as an scFv, the variable portion of the heavy and/orlight chains thereof, and a Fab miniantibody.
 9. The antibody-drugconjugate according to any of the preceding claims, wherein the antibodyis a monoclonal antibody.
 10. The antibody-drug conjugate according toany of the preceding claims, wherein the antibody is a humanised orfully human monoclonal antibody or antigen-binding fragment thereof. 11.The antibody-drug conjugate according to any of the preceding claims,wherein the antibody is a recombinant antibody.
 12. The antibody-drugconjugate according to any of the preceding claims, wherein the activeagent is selected from a therapeutic agent, a cytotoxic agent, aradioisotope and a detectable label.
 13. The antibody-drug conjugateaccording to any of the preceding claims, wherein the active agent is acytotoxic agent.
 14. The antibody-drug conjugate according to any of thepreceding claims, wherein the active agent is a chemotherapeutic agent,such as a chemotherapeutic agent selected from the group consisting ofalkylating agents, anthracyclines, antimetabolites,anti-microtubule/anti-mitotic agents, histone deacetylase inhibitors,kinase inhibitors, peptide antibiotics, platinum-based antineoplastics,topoisomerase inhibitors and cytotoxic antibiotics.
 15. Theantibody-drug conjugate according to any of the preceding claims,wherein the active agent is an anti-mitotic agent, such as selected fromthe group consisting of monomethyl auristatin E (MMAE), monomethylauristatin F (MMAF), a taxane (e.g. Paclitaxel or Docetaxel), a vincaalkaloid (e.g. Vinblastine, Vincristine, Vindesine or Vinorelbine),Colchicine or Podophyllotoxin.
 16. The antibody-drug conjugate accordingto any of the preceding claims, wherein the active agent is monomethylauristatin E (MMAE) or monomethyl auristatin F (MMAF).
 17. Theantibody-drug conjugate according to any of the preceding claims,wherein the active agent is a DNA-crosslinking agent, such as a DNAcrosslinking agent selected from pyrrolobenzodiazepine or a dimericpyrrolobenzodiazepine derivative.
 18. The antibody-drug conjugateaccording to any of the preceding claims, wherein the active agent is analkylating agent, such as Duocarmycin SA.
 19. The antibody-drugconjugate according to any of the preceding claims having adrug-to-antibody ratio (DAR) between 1 and 10, such as between 2 and 8,for example between 3 and 6, such as 4 or
 5. 20. The antibody-drugconjugate according to any of the preceding claims, wherein theantibody-drug conjugate comprises a linker selected from a cleavable anda non-cleavable linker.
 21. The antibody-drug conjugate according to anyof the preceding claims, wherein the linker is a peptide linker.
 22. Theantibody-drug conjugate according to any of the preceding claims,wherein the linker is an enzyme-cleavable peptide linker, such as acathepsin cleavable linker.
 23. The antibody-drug conjugate according toany of the preceding claims, wherein the linker comprises or consists ofa dipeptide, such as valine-citrulline (VC) or valine-alanine (VA). 24.The antibody-drug conjugate according to any of the preceding claims,wherein the antibody-drug conjugate further comprises a spacer, such asa spacer comprising paraaminobenzoic acid (PAB) or polyethylenglycol(PEG).
 25. The antibody-drug conjugate according to any of the precedingclaims, wherein the antibody-drug conjugate further comprises a spacerbeing or comprising PEG4.
 26. The antibody-drug conjugate according toany of the preceding claims, wherein the antibody-drug conjugate furthercomprises an attachment group, such as an attachment group comprising orconsisting of maleimide and caproic acid (MC), N-hydroxysuccinimide,azides or alkynes or being derived from these by reaction with theantibody.
 27. The antibody-drug conjugate according to any of thepreceding claims, wherein the antibody-drug conjugate comprises Vedotin(MC—VC-PAB-MMAE).
 28. The antibody-drug conjugate according to any ofthe preceding claims, wherein the antibody-drug conjugate comprises thefollowing linker-spacer-toxin unit: VC-PAB-MMAF.
 29. The antibody-drugconjugate according to any of the preceding claims, wherein theantibody-drug conjugate comprises the following linker-spacer-toxinunit: PEG4-VA-PBD.
 30. The antibody-drug conjugate according to any ofthe preceding claims, wherein the antibody-drug conjugate comprises thefollowing linker-spacer-toxin unit: PEG4-VC-DuocarmycinSA.
 31. Theantibody-drug conjugate according to any of the preceding claims for useas a medicament.
 32. A pharmaceutical composition comprising theantibody-drug conjugate according to any of the preceding claims, and apharmaceutically acceptable buffer, diluent, carrier, adjuvant orexcipient.
 33. A method for delivery of an active agent to a cellexpressing uPARAP comprising administering to said cell theantibody-drug conjugate according to any of claims 1 to 31 or thepharmaceutical composition according to claim 32, such that the activeagent is delivered to said cell.
 34. A method for treatment of a diseasecharacterised by cells expressing uPARAP in a subject comprisingadministering to the subject the antibody-drug conjugate according toany of claims 1 to 31 or the pharmaceutical composition according toclaim
 32. 35. The method according to claim 34, wherein the diseasecharacterised by cells expressing uPARAP is selected from cancer, a bonedegradation disease such as osteoporosis, fibrosis, and macrophageassociated diseases or disorders such as atherosclerosis or chronicinflammation.
 36. The method according to any of claims 34 to 35,wherein the disease is cancer.
 37. The method according to claim 36,wherein the cancer is selected from sarcoma, glioblastoma, prostatecancer, bone metastases from prostate cancer, breast cancer, head- andneck cancer and leukaemia.
 38. The method according to any of claims 36to 37, wherein the cancer is a solid tumour.
 39. The method according toany of claims 36 to 38, wherein the cancer is glioblastoma.
 40. Themethod according to any of claims 36 to 38, wherein the cancer issarcoma, such as osteosarcoma.
 41. The method according to any of claims33 to 40, wherein the antibody-drug conjugate is administeredparenterally, for example, intravenously, intracerebroventricularly,intraarticularly, intra-arterially, intraperitoneally, intrathecally,intraventricularly, intrasternally, intracranially, intramuscularly orsubcutaneously, or by infusion techniques.
 42. The method according toany of claims 33 to 41, wherein the antibody-drug conjugate isadministered intravenously.
 43. The method according to any of claims 33to 41, wherein the antibody-drug conjugate is administeredintracranially.
 44. The method according to any of claims 33 to 41,wherein the antibody-drug conjugate is administered subcutaneously. 45.The method according to any of claims 33 to 43, wherein theantibody-drug conjugate is administered in combination with one or morefurther agents, such as one or more further therapeutic agents.
 46. Themethod according to any of claims 33 to 45, wherein the cell expressinguPARAP displays uPARAP overexpression.
 47. The method according to anyof claims 33 to 46, wherein the cell expressing uPARAP is a tumour cell.48. The method according to any of claims 33 to 47, wherein the cellexpressing uPARAP is a tumour associated cell.
 49. The method accordingto any of claims 33 to 48, wherein the antibody-drug conjugate inducescell death and/or inhibits the growth and/or proliferation of the uPARAPexpressing cell.
 50. The method according to any of claims 34 to 49,wherein the treatment is ameliorative or curative.
 51. A method forinhibiting tumour progression in a subject, comprising administering tothe subject the antibody-drug conjugate according to any of claims 1 to31 or the pharmaceutical composition according to claim 32 to saidsubject.
 52. A method for inhibiting, lowering or eliminating metastaticcapacity of a tumour in a subject, comprising administering to thesubject the antibody-drug conjugate according to any of claims 1 to 31or the pharmaceutical composition according to claim 32 to said subject.53. A kit comprising the antibody-drug conjugate according to any ofclaims 1 to 31 or the pharmaceutical composition according to claim 32,optionally further comprising means for administering the antibody-drugconjugate to a subject and/or instructions for use.